Severe left scrotal pain after a blunt testicular trauma
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Ovoid-shaped heterogeneously hypoechoic area devoid of vascularity in the lower pole of the left testis. No convincing breach of the tunica albuginea. No evidence of hematocele. The contralateral testis appears normal. Normal appearances of the epididymi bilaterally.
In the trauma setting, the features are consistent with intra-testicular hematoma. The differential diagnosis is seminoma. However, the history of blunt testicular trauma, acute severe scrotal pain, inhomogeneity and lack of vascularity of the lesion make this possibility very less likely.