Fibroma of the Testis and Epididymis: A Case Report on a Testis-Sparing Management Approach

Paratesticular fibromas are rare benign lesions that may clinically mimic malignancy and lead to unnecessary orchiectomy.We report the case of a 22-year-old man who presented with a firm, painless right paratesticular mass that was suspicious for neoplasm on physical examination.Serum tumor markers were normal, and imaging demonstrated multiple well-circumscribed fibrous extratesticular lesions compressing, but not invading, the testis.Surgical exploration revealed multiple firm, whitish nodules involving the epididymis and testicular tunics, and testis-sparing excision was performed.Histopathologic examination showed well-circumscribed, collagen-rich spindle-cell lesions without cytologic atypia or mitotic activity, favoring benign paratesticular fibroma.At the six-month follow-up, the patient remained asymptomatic, with no evidence of recurrence on ultrasonography.This case illustrates the potential role of organpreserving surgery in carefully selected patients when imaging and intraoperative findings suggest a benign fibrous lesion and complete excision can be achieved without compromising oncologic safety.