Intra-Scrotal Adenomatoid Tumour Referred as an Extra Testis: A Case Report and Review of the Literature

“Background:” Intra-scrotal adenomatoid tumours are rare tumours which may present at any age and are usually treated by local excision. Ultrasound scan may help in the diagnosis but its capability to distinguish this lesion is low in view of the non specific ultrasonic features of the lesion. “Aims:” To report a case of intrasrotal adenomatoid tumour which was referred to a urologist as atrophic third testis after ultrasound scan examination To review the literature on adenomatoid tumours “Case Report:” A 48-years-old man was referred because he had noticed a painless lump in the left side of his scrotum. He had ultrasound scan of the testes and scrotal contents which was reported as showing: normal left testis and normal right testis and in addition a small solid lump in the left hemi-scrotum which the radiologist felt was most likely an atrophic extra testis (third testis). Clinical examination revealed normal left and right t e s t e s a s w e l l a s a 2 c m g l o b u l a r , smooth/homogenously palpable lump of firm/hard consistency abutting on the epididymis. A provisional diagnosis of adenomatoid tumour was made. The lesion was excised and its histological features were found to be consistent with adenomatoid tumour. He presented at follow-up clinic with a residual lump in the left hemi-scrotum which after ultrasound scan was reported by the radiologist to be consistent with persistence of adenomatoid tumour. However, clinically this lump was an organised haematoma which resolved and the patient remained well without a recurrence of the lump nine months post-operatively. “Conclusions:” Adenomatoid tumours are rare tumours with non-specific ultra-sonographic features in view of which the unaccustomed radiologist may misdiagnose it. Haematoma is certainly one of the differential diagnoses of adenomatoid tumour. Local excision should be the recommended form of treatment which has the advantage of confirming the diagnosis. There has not been any report of recurrence after local excision of the lesion.