MRI shows a heterogeneous left testicular mass measuring 5 x 5 x 3.5 cm. It has mixed solid and cystic components. Solid components are isointense on T1 and hypointense on T2 weighted images to the normal testis and show moderate enhancement on post-contrast scan. Multiple enhancing septa (low signal on T2 weighted images) are also seen in it. Solid components show diffusion restriction. The testicular lesion is involving the enlarged left epididymis. Minimal left hydrocele. The spermatic cord is normal.
Right testis and epididymis are normal. A few small bilateral inguinal lymph nodes.
These radiological features are suggestive of an aggressive neoplastic lesion (possibly seminoma).