Patient was assessed for testicular carcinoma markers, which was negative. Semen analysis was within normal limits. In view of sonographic features, patient was advised for follow-up. Patient is not willing for any surgical intervention at present. Provisional diagnosis of intratesticular AV malformation was considered, in view of predominantly vascular intratesticular lesion, with doppler features of AV malformation. While arterial feeders demonstrate low resistance arterial flow, draining channels are compressible, though pure venous waveform could not be appreciated.
Essential differential diagnosis to be considered is intratesticular varicocele, which will have venous waveform.