Scrotal mass differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Scrotal masses may be differentiated according to clinical features, laboratory findings, imaging features, histological features, and genetic studies from other diseases that cause testicular mass with discomfort, back pain, abdominal discomfort, or abdominal mass. Common differential diagnoses include yolk sac tumor, teratoma, choriocarcinoma, embryonal cell carcinoma, seminoma, and testicular lymphoma (usually non-Hodgkin lymphoma).

Differential Diagnosis

The table below summarizes the findings that differentiates scrotal mass according to the clinical features, laboratory findings, imaging features, histological features, and genetic studies.[1][2]

Scrotal Swelling Diseases Clinical manifestations Para-clinical findings Gold standard Associated
Painful Symptoms Physical examination
Lab Findings Past Medical History Histopathology
Unilateral /Bilateral swelling Onset Fever Urinary symptoms Tenderness Erythema Discharge Inguinal Lymphadenopathy Cremasteric Reflex Urine Analysis Doppler U/S
Epididymoorchitis Unilateral Gradual ± Dysuria, frequency, and/or urgency + _ Hydrocele Acute infection is characterized by infiltration of neutrophils. Chronic cases of epididymoorchitis, such as in sarcoidosis or tuberculosis, are characterized by granulomatous inflammation.
Testicular Torsion Unilateral Sudden - +
Torsion of testicular appendix +
Hematocele +
Incarcerated Hernia -
Testicular Abcess -
Brucellosis -
Mumps -
Histoplasma
Gonorrhea
Fournier's gangrene
Scrotal Swelling Diseases Unilateral /Bilateral swelling Lab 3 Fever Urinary symptoms Tenderness Erythema Discharge Inguinal Lymphadenopathy Cremasteric Reflex Urine Analysis Doppler U/S Past Medical History Histopathology Gold standard Additional findings
Painless Fragile XMacroorchidism - +
Testicular Tumors - +
Henoch-Schonlein purpura - -
Hydrocele - -
Varicocele - -
Spermatocele - -
Inguino-scrotal hernia - -
Scrotal edema - -
Epididymal cyst
Scrotal oedema
Sebaceous cyst
Carcinoma of the scrotum
Chylocele (Filariasis)
Cystic dysplasia
Srotoliths

References

  1. Unilateral testicular lesions. Dr Yuranga Weerakkody and Dr Vinod G Maller et al. Radiopaedia 2016. http://radiopaedia.org/articles/unilateral-testicular-lesions. Accessed on March 15, 2016
  2. Bilateral testicular lesions. Radiopaedia 2016. Dr Matt A. Morgan and Dr Vinod G Maller et al. Radiopaedia 2016. http://radiopaedia.org/articles/bilateral-testicular-lesions. Accessed on March 15, 2016