20 year old male with acute scrotal pain
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Ultrasound of the testes demonstrates the right testis to be enlarged, heterogeneous in echotexture, with without evidence of any blood flow.
Features are consistent with testicular torsion.
Specimen container labelled 'right testicle'. The specimen consists of a testis 45x30x30mm with attached epididymis 40x15x15mm, and spermatic cord with adjacent soft tissue 15x15mm. There is an intact tunica vaginalis with an underlying, diffusely congested tunica albuginea. Sectioning reveals a completely infarcted testicular and epididymal parenchyma with a diffusely haemorrhagic and congested dusky red cut surface. No discrete lesions are identified.
Sections of testis show extensive, variable interstitial congestion. Many of the seminiferous tubules have preservation of architecture and appear viable with active spermatogenesis, but in areas the seminiferous tubules appear necrotic. There are numerous ectatic, thin-walled vascular spaces external to the testicular capsule in the vicinity of the epididymis, with features suspicious for a varicocoele. The spermatic cord resection margin is unremarkable and includes a normal vas deferens and some congested blood vessels. There is no evidence of malignancy or intratubular germ cell neoplasia.
Right testis - testicular infarction, consistent with recent torsion and possible varicocoele.