Para-testicular neoplasms are extremely rare. We present here a case which was suspected on ultrasound examination. Histopathology indicated that this lesion was a paratesticular rhabdomyosarcoma. Ultrasound findings of the neoplastic process are briefly highlighted, and their correlation with clinical features is emphasized.
CASE REPORT
An 18-year-old-man attended the Out-patient Department of Urological Services with a history of a painless swelling in the scrotum on the left side of 2 months' duration. There was no history of trauma or fever. The swelling had increased in size gradually.
Local examination revealed a non-tender mass occupying the whole of the left hemiscrotum. The transillumination test was negative. There were no palpable inguinal lymph nodes. The right testis was normal. General physical examination and laboratory investigations were within normal limits.
With a clinical diagnosis of left epididymitid orchitis, the patient was sent to the x-ray Department for an ultrasound examination of the scrotum which revealed a large solid extra-testicular mass of mixed echogenecity. The epididymis could not be seen as whole, and the paratesticular area was occupied by the mass (Figure 1). The mass also showed an irregular hypoechoic area representing necrosis (Figure 2). The left testis was pushed anteriorly by the mass, and it showed low level echoes on its posterior aspect (Figure 2). There was no hydrocele.
An abdominal ultrasound examination showed a normal liver and spleen, and there was no evidence of retroperitoneal lymphadenopathy. A chest x-ray and a CT of the abdomen and pelvis were also normal.