The unsuspected nonpalpable testicular mass detected by ultrasound: a management problem

Ultrasound is recognized as a valuable method of detecting testicular masses. Rarely, ultrasound will detect a testicular mass that was not clinically suspected. We present the case of a 43-year old man who presented with an unsuspected testicular mass detected by ultrasound. He underwent inguinal orchiectomy. The pathology showed a Leydig Cell tumor with cytological atypia. A review of the literature suggests that most incidentally discovered testicular masses are tumors, but there is disagreement as to whether they are usually benign or malignant. In view of the fact that many of these lesions are benign, if tumor markers are not elevated, inguinal exploration and excision of the lesion with frozen section examination is an acceptable management approach.