Section Editor: Dharam M. Ramnani, MD

Virginia Urology, Richmond, VA, USA

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Image Description

Primary testicular hemangioma is a rare neoplasm. It occurs over a wide age range with a median age of 32 years. Most patients present with a testicular mass and occasionally with testicular pain or discomfort. Some cases have a history of pelvic irradiation, chemotherapy, or scrotal trauma. Ultrasonography shows a hypervascular lesion. Preoperative serum tumor markers are negative.

Case History: This adult male (> 60 yrs) presented with a slowly enlarging testis. There was no history of trauma. On examination, the involved testis was enlarged, firm, and non-tender. Ultrasound showed a heterogenous vascular mass replacing most of the testis. Serum tumor markers (AFP, beta-hCG, LDH) were within reference ranges. Radical orchiectomy was performed.

The orchiectomy specimen shows a well-circumscribed encapsulated hemorrhagic mass replacing most of the testis. Microscopic examination (see next six images) revealed an anastomosing hemangioma.

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