The use of high-resolution real-time ultrasound is becoming more widespread as a technique for evaluation of scrotal contents. Testicular versus extratesticular origins of pathology as well as cystic versus solid lesions can be distinguished with a high degree of accuracy. We report a case of benign epididymal mass simulating an intratesticular tumor.
CASE REPORT
A 39-yr-old man was evaluated for recurrent left testicular swelling and pain following testicular trauma two years before presentation. There were no urinary symptoms, and evidence of systemic disease was absent. Several courses of antibiotics resulted in the temporary relief of symptoms.
On physical examination there was a firm, enlarged, and mildly tender epididymis, but no palpable testicular mass. The opposite epididymis was also firm and slightly prominent, but nontender. All laboratory data were normal. The patient was referred to our ultrasound laboratory for evaluation.
A high-resolution real-time sonogram was obtained using a dedicated small-parts scanner (Picker Microview) with a nominal transducer frequency of either 8 or 10 MHz. The mechanical linear-motion transducer is housed within an adjustable, self-contained water bath. A digital scan converter allows both pre-and postprocessing data manipulation. The real-time technique allows a complete survey of scrotal contents.