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Age: 21

Sex: Male

Indication: Left testicular pain

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Case #30


Findings

  • Asymmetrically enlarged left testis with a predominantly cystic left testicular mass measuring 4.6 x 3.4 x 2.7 cm
  • The mass demonstrates thick internal septations with corresponding vascularity
  • Normal appearance of the right testis and of the bilateral epididymides
  • Normal vascularity in both testes with preserved arterial and venous waveforms
  • No hydrocele or varicocele


Diagnosis

Testicular tumor

Sample Report

Asymmetrically enlarged left testis with a predominantly cystic left testicular mass measuring 4.6 x 3.4 x 2.7 cm. This mass demonstrates thick internal septations with corresponding vascularity, which is very atypical for an abscess and instead raises concern for a testicular tumor. Recommend urology consultation.

Normal appearance of the right testis and of the bilateral epididymides. No evidence for testicular torsion.


Discussion

  • Testicular tumors often present in the context of acute symptoms like pain or swelling, which increases the risk of them being misdiagnosed as an acute condition like a testicular abscess
  • Testicular abscesses can have a very complex appearance but should not have internal vascularity, so if you see convincing vascularity within a testicular mass, you need to raise concern for neoplasm
  • This patient went to orchiectomy with pathology showing a mixed germ cell tumor



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