Elsevier

Urology

Volume 114, April 2018, Pages 175-180
Urology

Pediatric Case Reports
Pediatric Testicular Hemangioma in a 10-Year-old: A Rare Entity That May Mimic Malignancy With Appraisal of the Literature

https://doi.org/10.1016/j.urology.2017.12.022Get rights and content

Capillary hemangioma is a rare benign lesion in the testicle, particularly in pediatrics. It can mimic malignancy, leading to radical orchiectomy. We present a case of a testicular hemangioma in a child, and review the literature on testicular hemangiomas in this age group. A hypervascular testicular lesion without elevated tumor markers may warrant intraoperative biopsy to direct surgical management, which may include testis-sparing surgery if amenable.

Section snippets

Case Report

We present a case of a 10-year-old boy referred to pediatric urology with testicular asymmetry. At age 9, he was noted to have an enlarged left testicle by his pediatrician. This was observed with repeat examination in a year, at which time his pediatrician obtained a scrotal ultrasound, revealing an enlarged left testis (9.7 mL left vs 2.0 mL right) almost completely replaced with a moderately echogenic, hypervascular lesion measuring 2.7 × 1.8 × 2.2 cm (Fig. 1A) with a thin rim of

Comment

Vascular lesions rarely involve the testis, with few cases of capillary type hemangiomas described, and even fewer in prepubescent boys (Table 1).1, 2, 3, 4, 5, 6, 7, 8, 9 Testicular hemangiomas may clinically mimic neoplasms warranting aggressive management. In the largest pathology case series of testicular hemangiomas (n = 8), benign hemangiomas were misdiagnosed as angiosarcoma, Leydig cell tumor, and regressed germ cell tumor before second review.3 However, this series only included 1

Conclusion

We present a rare case of a prepubescent boy with a benign vascular testicular lesion that best fits the category of hemangioma. Testicular hemangiomas are uncommon but should be considered when a hypervascular lesion is noted on imaging, especially in children. If the lesion is small, tumor enucleation with TSS should be considered, given the likelihood of a benign lesion in the prepubescent age group.15

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Financial Disclosures: The authors declare that they have no relevant financial interests.

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