There is a heterogeneous soft tissue enhancing mass in the left scrotum superior to the left testis and involving the spermatic cord measuring 3.7 x 3.1 x 5.0 cm (AP x trans x CC). A small left hydrocoele is noted. The left and right testes are homogenous. This mass appears to be confined within the scrotal sac wall, with no extension into the subcutaneous tissue or skin. No left inguinal hernia.
No intra-abdominal lymphadenopathy. No hepatic lesion. The liver, spleen and adrenals are within normal limits. Simple cysts noted in both kidneys. Fatty atrophy of the pancreas. The small and large bowels are unremarkable.
No focal bony destructive lesion.
CONCLUSION: Heterogeneous soft tissue enhancing mass confined to left scrotal sac separate from the left testis, but involving the spermatic cord. No left inguinal hernia. This is concerning for a primary neoplastic process. 5 mm pulmonary nodule in the lateral segment of the right middle lobe and 11 mm left hilar lymphadenopathy as described.