[Hydrocele and cholesterol granuloma of the tunica vaginalis simulating a tumor in echography].

OBJECTIVE: A case of cholesterol granuloma of tunica vaginalis, with an equivocal ultrasound image but typical histopathological picture, is described. PATIENT AND METHOD: A 33-year-old man complained of a painless scrotal mass of 17 years duration. The mass was 10 cm in diameter, could not be transilluminated and appeared as paratesticular and solid on ultrasound, suggesting a tumor. At operation an old hydrocele with cholesterol crystals and cholesterol granuloma of tunica vaginalis was found. A partial resection of tunica vaginalis was performed, sparing the testis. COMMENT: Cholesterol granuloma is a rare inflammatory reaction of tunica vaginalis, that may simulate an intrascrotal tumor on physical examination, on ultrasound and at operation.