Adenomatoid tumours of the scrotum
Adenomatoid tumours of the scrotum are benign, solid extra testicular lesions that can originate from the epididymis, tunica vaginalis, or spermatic cord (90% derived from the funiculus).
They are the most common extra testicular 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.
Usually an incidental finding, adenomatoid tumours 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.
- well-defined solid extra testicular mass with variable echogenicity
- range in size from a few millimetres to a few centimetres
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
Treatment and prognosis
They are benign with no reports of recurrence or metastatic disease after excision 5.
General imaging differential considerations include:
- peritesticular lipoma
- peritesticular rhabdomyosarcoma
- peritesticular liposarcoma
- a rare condition in which more than two testes are present
- scrotal tuberculosis
Ultrasound - testicular and scrotal
- ultrasound (introduction)
testicular and scrotal ultrasound
unilateral testicular lesion
- testicular torsion
- testicular rupture
- germ cell tumours of the testis
- sex cord / stromal tumours of the testis
- bilateral testicular lesion
- paratesticular lesions
- tubular ectasia of the rete testis
- cystadenoma of the rete testis
- testicular sarcoidosis
- testicular tuberculosis
- spermatic cord
- fibrous pseudotumour of the scrotum
- scrotal leiomyosarcoma
- testicular adrenal rest tumours (TARTs)
- tunica vaginalis testis mesothelioma
- splenogonadal fusion
- unilateral testicular lesion
- 1. Kim W, Rosen MA, Langer JE et-al. US MR imaging correlation in pathologic conditions of the scrotum. Radiographics. 27 (5): 1239-53. doi:10.1148/rg.275065172 - Pubmed citation
- 2. Patel MD, Silva AC. MRI of an adenomatoid tumor of the tunica albuginea. AJR Am J Roentgenol. 2004;182 (2): 415-7. AJR Am J Roentgenol (full text) - Pubmed citation
- 3. Garriga V, Serrano A, Marin A et-al. US of the tunica vaginalis testis: anatomic relationships and pathologic conditions. Radiographics. 2009;29 (7): 2017-32. doi:10.1148/rg.297095040 - Pubmed citation
- 4. Goldberg BB, McGahan JP. Atlas of ultrasound measurements. Mosby Inc. (2006) ISBN:032303229X. Read it at Google Books - Find it at Amazon
- 5. Srigley JR, Hartwick RW. Tumors and cysts of the paratesticular region. Pathol Annu. 1990;25 Pt 2: 51-108. Pubmed citation