Presentation
Testicular discomfort with a palpable mass.
Patient Data
Well-defined left intratesticular ovoid mass of homogeneous low echogenicity as compared to the normal testicular tissue with no calcification or cystic component. No evidence of local invasion. Prominent internal blood flow is seen on color/Power Doppler.
an enlarged spermatic cord with mild surrounding effusion.
Normal appearance of the epididymis.
Normal appearance of the right testis (not shown).
There is a relatively well-defined ovoid left testicular mass measuring 38 x 32 x 28 mm. It elicits an isosignal to the normal testicular tissue on T1, low signal on T2 with heterogeneous enhancement and restricted diffusion on DWI-ADC. No evidence of extracapsular extension. Enlarged spermatic cord with mild surrounding effusion. Normal appearance of the epididymis.
Normal appearance of the right testis.
Small and bilateral inguinal lymph nodes (short axis <5 mm).
No distant metastasis or lymphadenopathy seen on the chest and abdominopelvic CT (not shown).
Case Discussion
The MRI features are highly suggestive of a malignant testicular tumor.
The patient underwent a radical orchiectomy with a histopathological exam that confirms the diagnosis of testicular seminoma.
Testicular seminomas are considered the most common testicular tumors, accounting for ~45% of all primary testicular tumors.
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