Paratesticular Tumor-Like Acquired Lesions

The range of paratesticular lesions that can mimic a tumor is very broad: meconium periorchitis, foreign body vaginalitis, scrotal calculi, cholesterol granuloma, vasitis nodosa, sperm granuloma, endometriosis, lipomembranous fat necrosis, pseudosarcomatous proliferation after testicular torsion, paratesticular cyst, fibrous pseudotumor, sclerosing lipogranuloma, and smooth muscle hamartomas, among others. In some cases the clinical history and the radiological findings suggest an etiology, e.g., in meconium periorchitis or scrotal calculi or in the case of vasitis nodosa or spermatic granuloma when there is a history of vasectomy. But most times, even in the above situations, the lesions start as tumor masses associated with the testis, the epididymis, or the spermatic cord, and a correct diagnosis can be reached only after their histological study. Although in most cases it is a classic pathology, there are two processes that deserve greater attention – pseudosarcomatous periorchitis secondary to torsion of the spermatic cord and the inclusion of fibrous pseudotumor in the growing list of IgG-related diseases.