Necrotizing epididymo-orchitis with intra-testicular abscess

Case contributed by Dr Mohammad A. ElBeialy


Right testicular pain, swelling, tenderness and fever since 6 weeks. The patient is presenting now with mild rigors, anorexia and some weight loss.

Patient Data

Age: 50 years
Gender: Male
  • The right testicle is seen enlarged with an intra-testicular marginally enhancing 6.6 X 5.4 X 5.3 cm cystic lesion. The lesion shows heterogenous predominantly hypointense T1 and hyperintense T2 signal intensity.
  • The right epididymis and the spermatic cord appear enlarged with heterogenous post-contrast enhancement as well as marginal enhancement of the epididymal head.
  • The right scrotal skin is seen oedematous and thickened with mild post-contrast enhancement.
  • Normal size and signal pattern of the left testicle with no intra-testicular mass lesion or abnormal signal.
  • Normal left epididymis and spermatic cord.
  • Mild left hydrocele is noted.
  • Bilateral enlarged inguinal lymphadenopathy are noted with heterogenous post-contrast enhancement as well.
  • Bilateral small oblique inguinal hernia with focal urinary bladder herniation into the right one.

Case Discussion

The above described findings are those of necrotizing epididymo-orchitis with intra-testicular abscess as well as epididymal head small abscess and acute funiculitis.

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Case information

rID: 29397
Published: 23rd May 2014
Last edited: 16th Jul 2018
System: Urogenital
Inclusion in quiz mode: Included

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