Adenomatoid paratesticular tumor: report of 5 new cases and literature review.

Objective: To report 5 cases of adenomatoid tumor of the epididymis that have been diagnosed in the last 11 years at our hospital. We performed a bibliographic review with discussion of diagnosis, differential diagnosis and treatment of this rare type of lesion.

Method: We have performed a retrospective analysis of epididymal adenomatoid tumors diagnosed during the last 11 years in our hospital, from January 2001 to June 2012.

Results: The average age of the series was 44 years. The predominant reason for consultation was long duration painless scrotal mass, with palpable nodule, usually dependent of the epididymis. 60% of the patients have been studied with abdominal ultrasound, which showed a nodular paratesticular lesion, with an echogenicity compatible with solid tissue. Tumor markers associated with testicular tumors (alpha-fetoprotein (AFP)), beta-human chorionic gonadotropin (b-HCG) and lactate dehydrogenase (LDH) were analyzed in 60% of the cases, being normal in all patients. 3 lumpectomies, 1 epididymectomy and 1 radical orchiectomy have been performed.

Conclusions: The discovery of a solid epididymal mass is uncommon in clinical practice. Physical examination and imaging tests should confirm the paratesticular origin of the lesion, being then trans-scrotal epididymectomy the treatment of choice. If diagnosis is uncertain, inguinal approach and intraoperative biopsy are mandatory.