Intrascrotal Extratesticular Schwannoma: A Rare Cause of Scrotal Mass

Abstract

Background: Schwannoma, also known as neurinoma, is the most common tumor of the peripheral nerves. Intrascrotal extratesticular schwannoma, which is not associated with schwannomatosis and neurofibromatosis-2, is a very rare entity and few cases have been reported in the literature. In this paper, we reported our case of extratesticular schwannoma, an extremely rare cause of scrotal mass, with ultrasound (US) and magnetic resonance imaging (MRI) findings. Case Report: A 22-year-old male presented with painless left scrotal swelling. Scrotal US showed an extra-testicular heterogeneous hypoechoic mass with lobulated contour in inferior part of scrotum. Scrotal MRI demonstrated well-defined extratesticular mass, which showed heterogeneous hypointens on T2 weighted-images compared with testis parenchyma. On contrast enhanced images, mass showed mild-modarate enhancement. The patient was underwent to surgery with the preliminary diagnosis of benign intrascrotal extratesticular mass. The lesion was removed with preservation of the testicles by urologists, and final diagnosis was made as scrotal schwannoma by histological and immunohistochemical examination Conclusion: Although there is no specific imaging finding of scrotal schwannoma, MRI can be used as a guide to surgery by helping to accurately determine whether the lesion is intra- or extratesticular. In addition, radiologists and urologists should keep schwannoma in mind in the differential diagnosis in the presence of an intrascrotal extratesticular mass.