TESTICULAR CAPILLARY HEMANGIOMA, REPORT A TWELVE YEAR PATIENT

Autori:

Anko Antabak, Dražen Jelašić, Tomislav Luetić, Matej Andabak, Stanko Ćavar, Klara Čogelja, Marko Bogović

Sažetak

Kapilarni hemangiom testisa iznimno je rijedak tumor. Prikazujemo slučaj testikularnog hemangioma u namjeri da skrenemo pozornost na rijetke benigne neoplazme i poštednu kirurgiju testisa zahvaćenog tumorom. Bolesnik je dvanaestogodišnji dječak, koji se prezentirao vodenom kilom i palpabilnim tumorom lijevog testisa. Ultrazvuk skrotuma i testisa pokazuje varikokelu II. stupnja, manji izljev u lijevom skrotumu te hipoehogenu zonu lijevog testisa veličine 5 mm u promjeru. Razina tumorskih markera u serumu (alfa-fetoproteina i beta-korionskoga gonadotropina) bila je u granicama referentnih vrijednosti. Intraoperativno je načinjena biopsija, a brza histološka analiza (na smrznutom preparatu) pokazuje kapilarni hemangiom. Potom je tumor potpuno odstranjen, a testis sačuvan. Klinički, ultrazvučnim nalazom i nalazom magnetske rezonancije hemangiomi se ne razlikuju od malignih solidnih tumora testisa. Intraoperacijska brza patohistološka dijagnoza određuje opsežnost kirurškog zahvata. Enukleacija hemangioma u zdravo tkivo testisa siguran je i opravdan kirurški zahvat.

Summary

Capillary hemangiomas of the testis are extremly rare tumors. We reported a case of intratesticular hemangioma, unusually localisation of this vascular benign neoplasm. The patient was 12 year old boy, with hydrocele and a palpabile testicular mass. Scrotal sonography revealed varicocele and hydrocele in the left scrotal sac. There was a solid hypoechogenic zone 5 mm in diameter in the left testis. Tumor markers like serum level of b human chorionic gonadotropin and a fetoprotein were normal. The patient underwent surgery, and intraoperativ frozen section showed a capillary hemangioma. The lesion was completly removed, but testis was preserved. Accordingly tu the literature, tumors of vascular origin are extremly rare. Capillary hemangiomas of the testis are similarity to malignant testicular solid tumors during physical examination, ultrasound examination and MR imaging. Before operation, it’s hardly differentiate tumors of testis, but intraoperativ frozen section cuold be helpfull to differentiate a hemangioma from other testicular mass. Hemangioma is benign, but lesion must be complete removed to avoid recurence. In cases capillarx hemangimas, tumor enucleation with preservation tissue of the testis is possible if intraoperative frozen section examination can be performed.