Presentation
Painless right testicular enlargement over a year.
Patient Data
Well-defined, bilobed, heterogeneously hypoechoic right testicular mass with internal vasularity. No calcifications. No extratesticular extension.
Normal left testicle.
Case Discussion
For this previously healthy young patient with a painless vascular unilateral testicular mass, the differential considerations are fairly limited.
While the differential diagnosis of a "unilateral testicular mass" includes many non-neoplastic and neoplastic etiologies, primary neoplasia remains the most common and important etiology.
Seminoma typically presents as a homogeneous hypoechoic hypovascular mass. Larger seminomas, as in this case, may be heterogeneous and hypervascular.
Right orchiectomy and pathology confirmed seminoma.