Paraganglioma of the Spermatic Cord: A Case Report and Literature Review of an Uncommon Entity.

Paragangliomas are rare neuroendocrine tumors that arise from extra-adrenal chromaffin cells. While their occurrence in the urogenital tract is itself uncommon, involvement of the spermatic cord is exceptionally rare. Because of their nonspecific clinical presentation, these tumors are often misdiagnosed as more common inguinoscrotal lesions. Herein, we present the case of a 13-year-old male patient who presented with a gradually enlarging, non-tender inguinal mass. The lesion was surgically excised, and histopathological examination revealed a well-circumscribed tumor composed of polygonal cells arranged in the characteristic Zellballen pattern, showing minimal nuclear atypia and low mitotic activity. Immunohistochemistry confirmed the diagnosis, with the tumor demonstrating diffuse positivity for synaptophysin and chromogranin A. The postoperative course was uneventful, and the patient remains disease-free at three years of follow-up. This case is particularly noteworthy given its occurrence in the pediatric age group and adds to the very few reported cases of spermatic cord paraganglioma in the literature. It highlights the importance of including this rare entity in the differential diagnosis of inguinoscrotal masses and reinforces the need for histopathological and immunohistochemical evaluation for definitive diagnosis. Given the potential for malignant behavior, complete surgical excision with long-term surveillance remains essential.