Adenomatoid Tumor of Epididymis

Adenomatoid tumors are benign neoplasms of mesothilial in origin and they account for 30% of paratesticular neoplasms.It is the most common benign tumor of the epididymis [1,2].They usually arise from the epididymal tail. About 14% can arise from Tunica Aibuginea.When the tumor arise from the deep layer of tunica Albuginea differentiation from intra testicular Germ cell tumor can be difficult [2]. Rare cases are reported where the tumor had involved the testicular parenchyma, ejaculatory ducts, spermatic cord, Prostate and suprarenal recess.
Adenomatoid tumor is a slow growing neoplasm, and the patient’s age at the time of presentation can vary from 18 to 79 years [1]. Clinical presentation is of a painless, firm scrotal mass measuring 1 to 5 cm. They are usually unilateral and are more common on the left side. It can be associated with a Hydrocele in 15% to20% of time [3].

Ultrasound appearance varies from Hypoechoic to Hyperechoic to Isoechoic, and does not show significant vascularity with color Doppler studies[1].

The main differential diagnosis of adenomatoid tumor is Lieomayoma, Papillary serous cyst adenoma, Lipoma and Hematoma.

Other lesions that can occur in epididymis include metastasis and spermgrannuloma’s.

Adenomatoid tumors are usually managed by intraoperative frozen section confirmation, followed by local excision. Adenomatoid tumor is a benign neoplasm with no reported cases of recurrence or metastasis after excision [3]