Multiparametric Ultrasound (mpUS) of a Rare Testicular Capillary Hemangioma

Capillary hemangioma is a rare entity among testicular tumors. We demonstrate the case of an 18-year-old patient with palpatoric and sonographic conspicuous left testicle and negative serum tumor markers (α-fetoprotein, β-human chorionic gonadotropin, and lactate dehydrogenase). Ultrasound (US) imag...

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Main Authors: Paul Spiesecke, Thomas Fischer, Carsten Stephan, Andreas Maxeiner, Bernd Hamm, Markus Lerchbaumer
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Radiology
Online Access:http://dx.doi.org/10.1155/2019/7568098
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author Paul Spiesecke
Thomas Fischer
Carsten Stephan
Andreas Maxeiner
Bernd Hamm
Markus Lerchbaumer
author_facet Paul Spiesecke
Thomas Fischer
Carsten Stephan
Andreas Maxeiner
Bernd Hamm
Markus Lerchbaumer
author_sort Paul Spiesecke
collection DOAJ
description Capillary hemangioma is a rare entity among testicular tumors. We demonstrate the case of an 18-year-old patient with palpatoric and sonographic conspicuous left testicle and negative serum tumor markers (α-fetoprotein, β-human chorionic gonadotropin, and lactate dehydrogenase). Ultrasound (US) imaging represented an isoechogenic lesion with high vascularization in both power Doppler and microflow imaging with central feeding artery. Both strain elastography and shear wave elastography demonstrated a stiff lesion compared to surrounding testicular tissue. While contrast-enhanced ultrasound (CEUS) clearly depicted high vascular load, time intensity curve (TIC) analysis was able to show shorter median transit time, higher peak enhancement, and higher wash-in area under the curve compared to regular testicular tissue. Histopathological examination revealed a lobular constructed and rich vascularized proliferation without cellular atypia and feeder vessels with positive reaction to CD34, CD31, CD99, and Vimentin. Proliferative activity was quantified to 3–5% by Ki-67 index. Two days after surgery, the patient could leave the hospital in subjective wellbeing. While histology remains the gold standard to make a precise diagnosis of capillary hemangiomas due to small case numbers and variety of this benign tumor, the combination of multiparametric US and clinical information may be a promising future tool in preoperative assessment.
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spelling doaj-art-6efa47beb60b4838bb47300417ce3c282025-02-03T06:08:31ZengWileyCase Reports in Radiology2090-68622090-68702019-01-01201910.1155/2019/75680987568098Multiparametric Ultrasound (mpUS) of a Rare Testicular Capillary HemangiomaPaul Spiesecke0Thomas Fischer1Carsten Stephan2Andreas Maxeiner3Bernd Hamm4Markus Lerchbaumer5Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyDepartment of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyDepartment of Urology and Berlin Institute for Urologic Research, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyDepartment of Urology and Berlin Institute for Urologic Research, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyDepartment of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyDepartment of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyCapillary hemangioma is a rare entity among testicular tumors. We demonstrate the case of an 18-year-old patient with palpatoric and sonographic conspicuous left testicle and negative serum tumor markers (α-fetoprotein, β-human chorionic gonadotropin, and lactate dehydrogenase). Ultrasound (US) imaging represented an isoechogenic lesion with high vascularization in both power Doppler and microflow imaging with central feeding artery. Both strain elastography and shear wave elastography demonstrated a stiff lesion compared to surrounding testicular tissue. While contrast-enhanced ultrasound (CEUS) clearly depicted high vascular load, time intensity curve (TIC) analysis was able to show shorter median transit time, higher peak enhancement, and higher wash-in area under the curve compared to regular testicular tissue. Histopathological examination revealed a lobular constructed and rich vascularized proliferation without cellular atypia and feeder vessels with positive reaction to CD34, CD31, CD99, and Vimentin. Proliferative activity was quantified to 3–5% by Ki-67 index. Two days after surgery, the patient could leave the hospital in subjective wellbeing. While histology remains the gold standard to make a precise diagnosis of capillary hemangiomas due to small case numbers and variety of this benign tumor, the combination of multiparametric US and clinical information may be a promising future tool in preoperative assessment.http://dx.doi.org/10.1155/2019/7568098
spellingShingle Paul Spiesecke
Thomas Fischer
Carsten Stephan
Andreas Maxeiner
Bernd Hamm
Markus Lerchbaumer
Multiparametric Ultrasound (mpUS) of a Rare Testicular Capillary Hemangioma
Case Reports in Radiology
title Multiparametric Ultrasound (mpUS) of a Rare Testicular Capillary Hemangioma
title_full Multiparametric Ultrasound (mpUS) of a Rare Testicular Capillary Hemangioma
title_fullStr Multiparametric Ultrasound (mpUS) of a Rare Testicular Capillary Hemangioma
title_full_unstemmed Multiparametric Ultrasound (mpUS) of a Rare Testicular Capillary Hemangioma
title_short Multiparametric Ultrasound (mpUS) of a Rare Testicular Capillary Hemangioma
title_sort multiparametric ultrasound mpus of a rare testicular capillary hemangioma
url http://dx.doi.org/10.1155/2019/7568098
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