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Focal orchitis presenting as bilateral testicular masses
1Department of Urology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd, Dallas, TX 75390-9110, USA.
Journal of Pediatric Urology
|October 25, 2008
Summary
Bilateral testicular masses in a teen resolved after surgery for inflammation, not cancer. This case highlights the importance of thorough work-up for testicular abnormalities to avoid unnecessary orchiectomy.
Area of Science:
- Pediatric Urology
- Diagnostic Imaging
- Pathology
Background:
- Testicular masses can present with scrotal pain.
- Hypoechoic and hypervascular testicular lesions on ultrasound require careful evaluation.
- Distinguishing inflammatory conditions from malignancy is crucial in pediatric patients.
Purpose of the Study:
- To report a case of bilateral testicular masses initially suspected to be malignant based on ultrasound findings.
- To emphasize the importance of comprehensive diagnostic work-up for testicular abnormalities.
- To highlight that inflammatory processes can mimic neoplastic lesions on sonography.
Main Methods:
- Case presentation of a 14-year-old male with bilateral scrotal pain.
- Diagnostic imaging using ultrasound with Doppler.
- Laboratory investigations including tumor markers and endocrinologic work-up.
- Surgical exploration and biopsy of testicular masses.
Main Results:
- Ultrasound revealed multiple bilateral hypoechoic and hypervascular testicular masses.
- Tumor markers and endocrinologic tests were within normal limits.
- Biopsy confirmed inflammation, with no evidence of malignancy.
- Postoperative resolution of pain and ultrasound-confirmed regression of masses.
Conclusions:
- Inflammatory testicular conditions can present sonographically similar to malignancy.
- Ultrasound findings alone should not dictate orchiectomy for testicular masses.
- A thorough diagnostic approach is essential for accurate diagnosis and appropriate management of pediatric testicular lesions.
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