Fibrous pseudotumor of the scrotum

Last revised by Jeremy Jones on 20 Sep 2021

Fibrous pseudotumor of the scrotum is a relatively rare, non-neoplastic extratesticular non-epididymal lesion.

It affects any age. Although rare, it is considered the third most common extra testicular mass after a scrotal lipoma and an epididymal adenomatoid tumor

Certain factors increases the risk of fibrous pseudotumor of the scrotum 5:

  • inflammatory hydrocele
  • trauma
  • surgery
  • infection 

It is characterized by usually nodular, probably reactive proliferation of fibrous tissue and inflammatory cells. It occurs due to prior inflammation, infection, or trauma. 

It most often involves the tunica vaginalis.

Sonographic appearances can be widely variable. They are typically seen as one or more solid paratesticular or tunica nodules or masses with variable echogenicity.

  • T1: uniformly low signal intensity: due to the presence of fibrosis 4
  • T2: uniformly low signal intensity: due to the presence of fibrosis 4
  • T1 (C+) Gd: generally show slow but persistent enhancement, as is typical of fibrous tissue, although enhancement can be variable 4

Clinically, it can mimic testicular malignancy. 

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