Intralesional Doppler Flow in Acute Scrotal Trauma Revealing Testicular Germ Cell Tumor: An Emergency Imaging Pitfall

A 39-year-old man presented with acute right testicular pain after minor blunt trauma. Scrotal ultrasound demonstrated a heterogeneous intratesticular lesion with internal Doppler vascularity, findings atypical for traumatic hematoma or infarction and suspicious for malignancy. Elevated serum alpha-fetoprotein and β-human chorionic gonadotropin levels supported the diagnosis. Radical orchiectomy confirmed a mixed postpubertal germ cell tumor. This case highlights the importance of Doppler evaluation during acute scrotal ultrasound and emphasizes awareness of diagnostic anchoring bias in emergency imaging assessment.