Adenomatoid tumors are rare benign neoplasms considered of mesothelial origin. They are usually asymptomatic and slow growing masses. They account for 30% of paratesticular tumors and very rarely involve the testicular parenchyma. Only ten such cases have been reported in the literature so far. Ideal treatment should be excision of the tumor avoiding orchidectomy. Nevertheless, because of the rarity of the lesion and the difficulty of distinguishing it from malignancy, radical orchidectomy is often performed. We describe a case of a 31 years old caucasian man who presented with a moderately symptomatic left testicular mass, normal tumor markers and normal sex hormones levels. The ultrasound showed an hypoechoic intratesticular nodule of 0.8 cm in diameter. The patient underwent intraoperative frozen section of the nodule which could not exclude malignancy with certainty. A radical orchiectomy was therefore performed. Subsequent definitive histological and molecular report described an adenomatoid tumor involving the parenchyma of the testis.
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