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Segmental testicular infarction: sonographic findings and pathologic correlation
Michael Aquino1, Hanh Nghiem, Syed Zafar Jafri
1Department of Radiology, Beaumont Health System, Royal Oak, MI 48071, USA.
Summary
Segmental testicular infarction can mimic testicular cancer on ultrasound, potentially leading to unnecessary surgery. Recognizing specific ultrasound patterns can aid diagnosis and prevent orchiectomy.
Area of Science:
- Radiology
- Pathology
- Urology
Background:
- Segmental testicular infarction (STI) can present with symptoms similar to testicular carcinoma.
- Accurate sonographic diagnosis is crucial to avoid unnecessary orchiectomy.
Observation:
- This case series correlates sonographic and histologic findings in 7 pathologically proven STI cases.
- Key sonographic features include geographic lesions with altered echogenicity and absent/near-absent flow in patients with scrotal pain.
Findings:
- A hyperechoic rim and peripheral hyperemia indicate interstitial hemorrhage and inflammation.
- Evolving infarcts become more discrete and hypoechoic, showing ghost outlines of seminiferous tubules.
Implications:
- Suspicion of STI on sonography warrants careful evaluation.
- Follow-up imaging or contrast-enhanced studies can increase diagnostic confidence and prevent unnecessary orchiectomy.
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