|Year : 2003 | Volume
| Issue : 2 | Page : 166-167
An intratesticular cavernous haemangioma mimicking a testicular malignancy
WAS de Silva, SAS Goonewardena
Department of Urology, National Hospital of Sri Lanka, Colombo, Sri Lanka
Consultant Urological Surgeon, College of Surgeons of Sri Lanka, 6, Wijerama Mawatha, Colombo 07
Source of Support: None, Conflict of Interest: None
Keywords: Testis, cavernous haemangioma.
|How to cite this article:|
de Silva W, Goonewardena S. An intratesticular cavernous haemangioma mimicking a testicular malignancy. Indian J Urol 2003;19:166-7
| Case Report|| |
A 15-year-old boy presented to his general practitioner with sudden onset of excruciating left-sided scrotal pain and swelling with accompanying pyrexia. He received a course of antibiotics with early subsidence of pain. However in view of the persisting testicular swelling he sought urological opinion 10 weeks later. He denied a history of trauma to the scrotum. Clinical examination revealed a hard, non-tender left testicular swelling suggestive of a left testicular neoplasm. The ipsilateral spermatic cord was normal. Ultrasound examination of the scrotum [Figure - 1] demonstrated the left testis (4.3 cm x 2.6 cm) with a heterogeneously hyperechoic mass lesion with multiple small hyperechoic areas within it. There was no associated varicocele or hydrocele.
Serology for β-HCG and α-fetoprotein was negative. A clinical and radiological diagnosis of testicular neoplasm was made. Surgical exploration of the left scrotal contents was performed through arr inguinal approach. There was no evidence of torsion of the spermatic cord. An orchidectomy was carried out.
Gross appearance of the bisected testis (4 x 3 x 2.5 cm) showed a haemorrhagic tumour occupying the upper part (3 x 2 x 2 cm) with vascular spaces and blood clots. Microscopy of the haemorrhagic tumour revealed a cavernous haemangioma composed of variable sized, dilated blood-filled cavernous spaces separated by fibrous and adipose tissue [Figure - 2]. The entire testicular tissue was infarcted.
| Comments|| |
Haemangioma of the testis is a rare condition. This benign vascular neoplasm may arise either within the testicular parenchyma (intratesticular) as in this case or from adnexal structures of the testis (extratesticular). Intratesticular haemangioma is rarer than extratesticular form. These lesions are probably hemartomatous malformations of resident vessels that are present at birth.  Although these lesions are benign, they may give rise to haemorrhage and acute infarction of the testis.  The fact that this patient had severe scrotal pain at the outset could be attributed to the acute infarction of the testicular tissue.
| Acknowledgement|| |
The authors wish to acknowledge the support of Dr. MVC de Silva MD (Col), Senior Lecturer in Pathology, Faculty of Medicine, University of Colombo.
| References|| |
|1.||Chetty R. Bandid S, Freedman D. Cavernous haemangioma of the epididymis mimicking a testicular malignancy. Aust NZJ Surg 1993; 63: 235-7. |
|2.||Fosum BD, Wools JC, Blight EM. Cavernous haemangioma of the testis causing acute testicular infarction. Urology 1981; 18: 277-8. |
[Figure - 1], [Figure - 2]