Giant Adenomatoid Tumor of the Tunica Albuginea Presenting as Chronic Scrotal Swelling in an Elderly Male: A Report of a Rare Case

Paratesticular tumors are uncommon intrascrotal neoplasms involving a heterogeneous group of benign and malignant lesions. Adenomatoid tumor accounts for only 1-2% of all scrotal tumors. Although adenomatoid tumors are the most prevalent benign neoplasms of the paratesticular region and commonly arise from the epididymis, primary involvement of the tunica albuginea remains rare. Such an unusual imaging presentation might resemble that of malignant tumors (like liposarcoma, leiomyosarcoma, and rhabdomyosarcoma), posing a diagnostic challenge. We report a 60-year-old male with a 15-year history of scrotal swelling and recent onset of mild dragging and low-grade pain. Subsequent scrotal ultrasound and contrast-enhanced MRI were performed, followed by surgery and histopathological examination (HPE), which confirmed an adenomatoid tumor arising from the tunica albuginea. Unlike the typically small lesions seen in younger adults, this case involved a giant adenomatoid tumor arising from the tunica albuginea in an older patient, highlighting its unusual presentation.