\[ -4 a-4 x^2+\left (x y'(x)+y(x)+2 x\right )^2-4 x y(x)=0 \] ✓ Mathematica : cpu = 0.490861 (sec), leaf count = 22
\[\left \{\left \{y(x)\to \frac {-a-2 c_1 x+c_1^2}{x}\right \}\right \}\]
✓ Maple : cpu = 0.242 (sec), leaf count = 32
\[ \left \{ y \left ( x \right ) =-{\frac {{x}^{2}+a}{x}},y \left ( x \right ) ={\it \_C1}+{\frac {1}{x} \left ( {\frac {{{\it \_C1}}^{2}}{4}}-a \right ) } \right \} \]