Testicular hypoperfusion

Case contributed by Dr Jason Robert Young

Presentation

58 year old male with acute left scrotal pain.

Patient Data

Age: 58
Gender: Male
Nuclear medicine

Nuclear Medicine Testicular Scan using 12.0 mCi Tc99m Free Pertechnetate

Photopenic left testicle with "hot rim" sign. 

Ultrasound

Corresponding Ultrasound

Absent color and spectral Doppler signal in the left testicle.  Enlarged and heterogeneous left testicle.  

Case Discussion

Patient initially presented to the emergency room with acute left scrotal pain.  An ultrasound was interpreted as left testicular torsion.  Urology was consulted and recommended a nuclear medicine testicular scan, given low likelihood of torsion in a 58 year old.  The nuclear medicine testicular scan was interpreted as ischemic change to the left testicle, possible etiologies including testicular torsion, embolic atherosclerotic disease, entrapped left inguinal hernia or abdominopelvic mass impairing gonadal artery blood flow.  

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Case information

rID: 30538
Case created: 17th Aug 2014
Last edited: 10th Sep 2015
System: Urogenital
Inclusion in quiz mode: Included

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