Adenomatoid tumors of the scrotum
Citation, DOI & article data
They are the most common extratesticular neoplasm, and most common tumor 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 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.
- well-defined, usually oval extratesticular mass with variable echogenicity although most are isoechoic to the epididymis 6
- usually solid although can be completely cystic 6
- range in size from a few millimeters to a few centimeters
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 5,6.
General imaging differential considerations include:
- peritesticular lipoma
- peritesticular rhabdomyosarcoma
- peritesticular liposarcoma
- supernumerary testes: a rare condition in which more than two testes are present
- scrotal tuberculosis
- 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
- 6. Syed Ali Akbar, Tawfeeq Amjadali Sayyed, Syed Zafar Hasan Jafri, Farnaz Hasteh, James Simeon Adams Neill. Multimodality Imaging of Paratesticular Neoplasms and Their Rare Mimics1. (2003) RadioGraphics. doi:10.1148/rg.236025174