IgG4-related para-testicular fibrous pseudotumor- A rare benign testicular mass mimicking malignancy: A case report and literature review

Abstract

Para-testicular fibrous pseudotumors (PFP) are rare benign reactive lesions comprising of 6 % of para-testicular masses. Often misdiagnosed as malignant due to clinical and radiological overlap, they are frequently treated with aggressive surgery. We report a case of a 70-year-old male with a left inguinal swelling diagnosed post-orchidectomy as PFP. Histopathology revealed collagen-rich fibrotic tissue with lymphoplasmacytic infiltrates and IgG4-positive plasma cells. While PFP treatment requires surgical resection, testicle-sparing procedures with intraoperative frozen section assessment may prevent unnecessary orchidectomy. Further studies are needed to establish diagnostic protocols and explore the association between PFP and IgG4-related diseases.