Scrotal mass differential diagnosis: Difference between revisions
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Revision as of 19:58, 23 January 2019
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Scrotal Mass Microchapters |
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Scrotal mass differential diagnosis On the Web |
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American Roentgen Ray Society Images of Scrotal mass differential diagnosis |
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Risk calculators and risk factors for Scrotal mass differential diagnosis |
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.
| 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 | ||||||
| Epididymitis[1] | Unilateral | Gradual | ± | Dysuria, frequency, and/or urgency | + | _ | Pyuria | Painful local lymphadenopathy | + | Enlarged (>17 mm) epididymis with a hypoechoic, hyperechoic, or heterogeneous echotexture, increased blood flow | Hydrocele |
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| Orchitis | Unilateral or bilateral | Abrupt | ± | Dysuria | + | - | ± | Painful local lymphadenopathy | + | Leukocytosis |
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| Testicular Torsion[2] | Unilateral | Sudden | - | + | + | Blood in semen | - | Normal | Absent or decreased arterial perfusion of the testis |
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| Torsion of testicular appendix | Unilateral | Sudden | - | + | + | - | - | Normal | Absent or decreased arterial perfusion of the testis | prepubertal period | ||||||
| Hematocele | Unilateral or bilateral | Sudden | - | + | + | Blood in semen | ||||||||||
| Incarcerated Hernia[3][4] | Unilateral | Sudden | + | - | + | + | - | Absent | ||||||||
| Testicular Abcess | - | |||||||||||||||
| Brucellosis | - | |||||||||||||||
| Histoplasma | ||||||||||||||||
| Gonorrhea | ||||||||||||||||
| Fournier's gangrene | ||||||||||||||||
| Scrotal Swelling | Diseases | Unilateral /Bilateral swelling | Onset | 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 | Bilateral | - | + | ||||||||||||
| Testicular Tumors | ± | + | ||||||||||||||
| Henoch-Schonlein purpura | - | - | ||||||||||||||
| Hydrocele[5] | Gradual | _ | - | - | - | Ultrasound:
simple fluid collection |
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| Varicocele[6] | Unilateral
(Mainly left) |
Gradual | Local warmth | - | ± | - | Absent | Ultrasonography:
tortuous, tubular, anechoic structures adjacent to the testis corresponding to dilated veins of the pampiniform plexus with calibers of 2–3 mm during the Valsalva maneuver |
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| Spermatocele[7] | Gradual | - | - | - | Absent |
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Ultrasonography:
hypoechoic with posterior acoustic enhancement |
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| Inguino-scrotal hernia[8][3] | - | - | Absent | |||||||||||||
| Scrotal edema | - | - | ||||||||||||||
| Epididymal cyst[9] | ± | Ultrasonography::
posterior acoustic enhancement, well defined anechoic lesions, larger cysts may contain septations |
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| Scrotal oedema | ||||||||||||||||
| Sebaceous cyst | ||||||||||||||||
| Carcinoma of the scrotum | ||||||||||||||||
| Chylocele (Filariasis) | ||||||||||||||||
| Cystic dysplasia | ||||||||||||||||
| Srotoliths | ||||||||||||||||
References
- ↑ Yu KJ, Wang TM, Chen HW, Wang HH (2012). "The dilemma in the diagnosis of acute scrotum: clinical clues for differentiating between testicular torsion and epididymo-orchitis". Chang Gung Med J. 35 (1): 38–45. PMID 22483426.
- ↑ Gunther P, Schenk JP, Wunsch R, Holland-Cunz S, Kessler U, Troger J, Waag KL (November 2006). "Acute testicular torsion in children: the role of sonography in the diagnostic workup". Eur Radiol. 16 (11): 2527–32. doi:10.1007/s00330-006-0287-1. PMID 16724203.
- ↑ 3.0 3.1 Jenkins JT, O'Dwyer PJ (2008). "Inguinal hernias". BMJ. 336 (7638): 269–72. doi:10.1136/bmj.39450.428275.AD. PMC 2223000. PMID 18244999.
- ↑ Berger D (2016). "Evidence-Based Hernia Treatment in Adults". Dtsch Arztebl Int. 113 (9): 150–7, quiz 158. doi:10.3238/arztebl.2016.0150. PMC 4802357. PMID 26987468.
- ↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.
- ↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.
- ↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.
- ↑ Berger D (2016). "Evidence-Based Hernia Treatment in Adults". Dtsch Arztebl Int. 113 (9): 150–7, quiz 158. doi:10.3238/arztebl.2016.0150. PMC 4802357. PMID 26987468.
- ↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.