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Background <p>Benign tumors of the spermatic cord constitute the majority of paratesticular tumors. Fibrolipomas are unusual in adults; however, there are no known cases involving the spermatic cord in children.</p> Case presentation <p>A male patient, aged 13, arrived at the emergency department complaining of right inguinoscrotal pain and nausea for the past four days. The genital examination of the patient revealed a tender, freely movable mass located in the right scrotum above the testicle. Doppler scrotal ultrasound demonstrated a soft tissue structure measuring 48 × 19&#xa0;mm with heterogeneity and absence of vascular activity located along the spermatic cord in proximity to the right testicle. Right scrotal tenderness and absence of blood supply on Doppler ultrasound indicated emergency surgical intervention, considering the possibility of torsion in an accessory testicle, more frequently encountered in pediatrics. Surgical exploration of the inguinal region and mass excision were conducted. The pathology report determined a tumor exhibiting collagenized tissues surrounding fatty lobules, indicative of a fibrolipoma.</p> Conclusions <p>To our knowledge, this pediatric patient represents the first reported case of spermatic cord fibrolipoma. Although benign, fibrolipomas can present with acute scrotal symptoms and mimic more urgent conditions, such as torsion of an accessory testis. The possibility of fibrolipoma, while rare, should be considered in the differential diagnosis of a paratesticular mass to prevent misdiagnosis and potential testicular compromise. Optimal outcomes depend on early detection, accurate imaging, and prompt surgical intervention.</p>

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First pediatric case of spermatic cord fibrolipoma: case report and literature review

  • 期刊论文

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  • 发表日期：

    2025年4月2日

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  • Agah Koray Mansiroglu,
  • Abdullah Duman,
  • Seher Deniz

摘要

Background

Benign tumors of the spermatic cord constitute the majority of paratesticular tumors. Fibrolipomas are unusual in adults; however, there are no known cases involving the spermatic cord in children.

Case presentation

A male patient, aged 13, arrived at the emergency department complaining of right inguinoscrotal pain and nausea for the past four days. The genital examination of the patient revealed a tender, freely movable mass located in the right scrotum above the testicle. Doppler scrotal ultrasound demonstrated a soft tissue structure measuring 48 × 19 mm with heterogeneity and absence of vascular activity located along the spermatic cord in proximity to the right testicle. Right scrotal tenderness and absence of blood supply on Doppler ultrasound indicated emergency surgical intervention, considering the possibility of torsion in an accessory testicle, more frequently encountered in pediatrics. Surgical exploration of the inguinal region and mass excision were conducted. The pathology report determined a tumor exhibiting collagenized tissues surrounding fatty lobules, indicative of a fibrolipoma.

Conclusions

To our knowledge, this pediatric patient represents the first reported case of spermatic cord fibrolipoma. Although benign, fibrolipomas can present with acute scrotal symptoms and mimic more urgent conditions, such as torsion of an accessory testis. The possibility of fibrolipoma, while rare, should be considered in the differential diagnosis of a paratesticular mass to prevent misdiagnosis and potential testicular compromise. Optimal outcomes depend on early detection, accurate imaging, and prompt surgical intervention.