Testicular extravaginal torsion

Case contributed by Dr Paul Adamoli

Presentation

At birth, the left testis shows increased volume and consistency. It was visible as a little dimple on the medial surface of the left thigh, probably as consequence of a localized ischemia.

Patient Data

Age: Newborn
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Ultrasound

Ultrasound - day 2 of life

The left testis measures mm 10.5 x 8.4 mm and volume 0.394 ml; the gonad shows heterogenously reduced echogenicity; the tunica albuginea appears thickened and appears echogenic due to calcification.

Utrasound of the scrotum one month later shows in the left hemiscrotum hypo/anechoic content formation, hyperechoic margin which has 1.1 mm thick, due to the tunica albuginea calcification . Inside this formation is not recognized anything referred to the gonad.

The right testis measures mm 12.1 x 7.9 and volume is ml 0.491; regular ecotexture; regular epididymis; the testis floats in an anechoic fluid as in hydrocele. 

In summary:

The sonographic findings at birth suggests extra-vaginal torsion in testes.

The presence of calcifications in the tunica albuginea is caused by a chronic torsion, dated average 8 weeks before the scan.

The ultrasound scan taken one month later confirms a gonadal atrophy.
 

Case Discussion

It is plausible that, torsion occurred at 30th week of pregnancy, just after the beginning of the descent of the testis in the inguinal canal.

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Case information

rID: 16601
Published: 1st Feb 2012
Last edited: 21st Nov 2020
Inclusion in quiz mode: Excluded

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