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Adenomatoid tumours of the scrotum

Dr Ian Bickle and Radswiki et al.

Adenomatoid tumours of the scrotum are benign, solid extratesticular lesions that can originate from the epididymis, tunica vaginalis, or spermatic cord(90% derived from the funiculus).

Epidemiology

They are the most common extratesticular neoplasm, and most common tumour of the epididymis, and occur more often in the lower pole than in the upper pole by a ratio of 4:1.

Clinical presentation

Usually an incidental finding, adenomatoid tumors manifest as a small (usually under 2 cm)painless scrotal mass, with the majority diagnosed in patients aged 20 - 50 years. They are typically unilateral and occur more frequently on the left side.

When they grow non-invasively into the testicular parenchyma, they can simulate intratesticular disease.

Radiographic features

Ultrasound

On ultrasound they appear as a well defined solid extratesticular mass with variable echogenicity.

MRI

MR imaging can aid in determining the paratesticular origin of the lesion.

  • T2 - low signal intensity relative to the testicular parenchyma
  • T1 C+ (Gd) - show enhancement

Differential diagnosis

General imaging differential considerations include :

  • testicular lipoma
  • testicular rhabdomyosarcoma
  • testicular liposarcoma
  • supernumerary testes(a rare condition in which more than
    two testes are present)
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