Scrotal mass differential diagnosis: Difference between revisions

Latest revision as of 15:16, 23 October 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Niloofarsadaat Eshaghhosseiny, MD [2] Preeti Singh, M.B.B.S.[3]

Overview

Scrotal masses must be differentiated from other diseases that cause scrotal swelling,scrotal pain,such as testicular tortion ,epididimitis,testicular tumors,inguinal herniation and many other diseases.

Differentiating Scrotal masses from the other Diseases

Scrotal masses must be differentiated from other diseases that cause scrotal swelling,scrotal pain,such as testicular tortion ,epididimitis,testicular tumors,inguinal herniation and many other diseases.

The table below summarizes the findings that differentiates scrotal mass according to the clinical features, laboratory findings, imaging features, histological features, and genetic studies.

	Symptoms				Physical examination					Lab Findings		Past Medical History	Histopathology
Diseases	Clinical manifestations									Para-clinical findings				Gold standard	Associated
	Symptoms				Physical examination					Para-clinical findings
	Unilateral /Bilateral swelling	Onset	Fever	Urinary symptoms	Tender -ness	Erythema	Discharge	Inguinal Lymphadenopathy	Cremasteric Reflex	Blood/Urine Analysis	Doppler U/S	Past Medical History	Histopathology
Painful
Epididymitis^[1]^[2] ^[3]^[4]^[5]^[6]^[7]^[8]	Unilateral	Gradual	±	Dysuria, frequency, and/or urgency	+	-	+ (Pyuria Bacteriuria)	Painful local lymphadenopathy	+	CBC-Leukocytosis Urine culture (pre-pubertal and elderly) NAAT Immunofluorescent antibody testing	Decreased epididymal blood flow	Enlarged (>17 mm) epididymis with a hypoechoic, hyperechoic, or heterogeneous echotexture, increased blood flow	Acute infection is characterized by infiltration of neutrophils. Chronic cases are characterized by granulomatous inflammation.	Ultrasound for diagnosis (Testicular massesor swollen testicles with hypoechoic and hypervascular areas)	Hydrocele Urinary tract infection Gonococcal infection chlamydia infection Phen sign +ve
Orchitis (Mumps)^[9]^[10]^[11]^[12] ^[13]^[8]^[7]^[14]	Bilateral	Abrupt	±	Dysuria	+	-	±	Painful local lymphadenopathy	+	CBC-Leukocytosis raised CRP Immunofluorescent antibody testing Urine analysis and culture - normal	Increased blood flow in affected side.	Mumps, coxsackievirus infection Concurrent epididymitis Congenital abnornmalities	Tubules are infiltration with neutrophiles, lymphocytes and cells resembling histiocytes Microscopic destruction of spermatogenic cells	RT‐PCR Serum immunofluorescence antibody testing.	Phen sign +ve Testicular atrophy Infertility
Testicular Torsion^[15]^[16]^[17]^[18]^[19]^[7]	Unilateral	Sudden	-	Absent	+	+	+ Blood in semen may be present	Absent	-	Normal	Absent or decreased arterial perfusion of the testis	Previous history of testicular torsion Family history of testicular torsion Prematurity Undescended testes Low birth weight	In the first 4 hours: testicular parenchyma shows edema and and desquamation of the germ cells 4-8 hours partial necrosis of germ cells. >24 hrs: necrosis	Doppler ultrasound> CT scan	Phen sign +ve
Hematocele^[20]^[21] ^[22]^[23]^[24]	Unilateral or bilateral	Sudden	-	Absent	+	+	+ Blood in semen	Absent	-	Urinalysis may be the only indication of injury to urinary tract Hematuria.	Scrotal wall thickening and testicular hematoma	Testicular trauma related to: Sports injuries. Direct trauma Motor vehicle accidents Straddle injuries	Increased destruction and fibrosis of the dartos fascia,. Dense inflammatory cells, necrotic areas and destruction of the muscular layer.	Ultrasonography: to check for testicular rupture.	_
Incarcerated Hernia^[25]^[26]	Unilateral	Sudden	+	Absent	+	+	-	Absent	+	Normal	Normal	-	-	Groin ultrasound or CT scan show presence of bowel and omentum.	Valsalva maneuvers performed while palpating the inguinal canal will push a hernia against the examiner's finger.
Brucellosis^[27]^[28]^[29]^[30]	Unilateral or Bilateral	Sudden	±	Dysuria	-	-	±	Painful local lymphadenopathy	+	CBC-Leukocytosis raised CRP Immunofluorescent antibody testing Urine analysis and culture - normal	Increased blood flow in affected side	-	Acute infection is characterized by infiltration of neutrophils. Chronic cases are characterized by granulomatous inflammation.	Culture of the organism from blood.	Antibodies are detected using: Serum agglutination (standard tube agglutination) Enzyme-linked immunosorbent assay Rose Bengal agglutination Coombs test Immunocapture agglutination (Brucellacapt) 2-mercaptoethanol agglutination
Torsion of the appendix testis^[31]^[32]^[33]^[34]	Unilateral or Bilateral	Sudden	-	Absent	+	-	-	Absent	+	Normal	Normal blood flow to the testis with an occasional increase on the affected side	-	In the first 4 hours: testicular appendages shows edema and and desquamation. 4-8 hours partial necrosis of appendix cells. >24 hrs: necrosis	scrotal ultrasound shows the torsed appendage as a lesion of low echogenicity with a central hypoechogenic area.	Scrotal wall mayshow the classical "blue dot" sign, which is due to infarction and necrosis of the appendix testis
Henoch-Schonlein purpura^[35]^[36]^[37]^[38]	Unilateral	Sudden	-	Absent	+	+	-	-	-	Serum IgA levels are elevated Elevated ESR	-	Sore throat 2-3 weeks back	Light microscopy shows leukocytoclastic vasculitis in postcapillary venules with IgA deposition	Biopsy	Palpable purpura Age at onset is less than 20 years Acute abdominal pain
Fournier's gangrene^[39]^[40]^[41]^[42]	Bilateral	Sudden	+	Absent	+	+	-	-	+	Leukocytosis Acidosis Elevated ESR and CRP Blood cultures are positive in majority of patient for streptococcus.	-	-	-	Computed tomography (CT) scan shows most useful finding is presence of gas in soft tissues.	Patient show signs of tense edema outside the involved skin, blisters, bullae, crepitus, and subcutaneous gas.
Diseases	Unilateral /Bilateral swelling	Onset	Fever	Urinary symptoms	Tender<be>-ness	Erythema	Discharge	Inguinal Lymphadenopathy	Cremasteric Reflex	Blood/Urine Analysis	Doppler U/S	Past Medical History	Histopathology	Gold standard	Additional findings
Painless
Fragile X Macroorchidism^[43]^[44]^[45]^[46]	Bilateral	Gradual	-	Absent	-	-	+	Absent	+	Normal	-	-	Increased volume of testis	FMR1 DNA analysis	Long and narrow face with prominent forehead and chin (prognathism) Large ears Intellectual Disability
Testicular Tumors^[47]^[48]^[49]^[50]	Unilateral or bilateral	Gradual	±	Absent	±		+	Present	+	Increased serum beta-hCG or alpha fetoprotien (AFP)	-	-	Seminoma shows findings such as: Large cells with watery cytoplasm Fried egg appearance	Biopsy	Pain in the back or abdomen Ascites Weight loss Gynecomastia Precocious Puberty Infertility
Hydrocele^[51]^[52]^[53]^[54]^[55]	Bilateral	Gradual	-	Absent	-	-	-	Absent	+	-	Normal	-	-	Ultrasound: simple fluid collection	Transillumination test is positive
Varicocele^[56]^[57]^[58]^[59]	Unilateral (Mainly left)	Gradual	Local warmth	Absent	-	±	-	Absent	+	Elevations in unstimulated luteinizing hormone and follicle stimulating hormone levels may be seen in when associated with infertility in adults	Thrombosis of Inferiror vena cava Thrombosis of Right renal vein Abdominal mass	Renal cancer Nephrectomy Nut-cracker syndrome	-	Ultrasonography: tortuous, tubular, anechoic structures adjacent to the testis corresponding to dilated veins of the pampiniform plexus with calibers of 2–3 mm during the Valsalva maneuver	Infertility
Spermatocele^[60]^[55]^[61]	Unilateral	Gradual	-	Absent	-	-	-	Absent	+	-	Falling snow, resulting from internal echoes moving away from the transducer	Epididymitis Trauma	Epididymal scarring is seen	Ultrasonography: hypoechoic with posterior acoustic enhancement	Transillumination test is positive
Scrotal edema^[62]^[63]	Bilateral and can extend to perineum	Gradual	-	Absent	-	-	-	Absent	+	Eosinophilia Hypoalbuminemia Hyperlipidemia. Proteinurea	Deep Vein Thrombosis	Nephrotic Syndrome Hepatic Cirrhosis Insect Bite	-	Kidney or Liver biopsy	Occurs between 4-12 years of age.
Sebaceous cyst^[64]^[65]^[66]	Unilateral	Gradual	-	Absent	-	-	-	Absent	+	-	Normal	-	Fibrous tissues and fluids A fatty,(keratinous), substance that resembles cottage cheese,. A viscous, serosanguinous fluid (containing purulent and bloody material).	Histological examination	Freely movable on palpation.
Carcinoma of the scrotum^[67]^[68]^[69]	-	Gradual	-	Absent	-	-	-	Absent	+	-	Normal	-	keratinocytic dysplasia involving the full thickness of the epidermis without infiltration of atypical cells into the dermis. The keratinocytes are pleomorphic with hyperchromatic nuclei Numerous mitoses are present.	Biopsy	Scaly patch or plaque is seen over the testis.
Chylocele (Filariasis)^[70]^[71]^[72]	Unilateral or Bilateral	Gradually Rapidly	+	Absent	-	-	-	Absent	+	Circulating filarial antigen (CFA) assays are positve	Lymphatics containing worms can be differentiated from the blood vessels by irregular movement	-	-	CFA assay	Ultrasound demonstrates living worms which has been described as "filarial dance" sign.
Scrotoliths^[73]^[74]^[75]	Unilateral	Gradual	-	Absent	-	-	-	Absent	+	-	Normal	Trauma Torsion of appendix	-	Ultrasound	Ultrasound shows mobile hyperechoic extratesticular focus in the potential tunica space.

References

↑ Yu KJ, Wang TM, Chen HW, Wang HH (2012). "The dilemma in the diagnosis of acute scrotum: clinical clues for differentiating between testicular torsion and epididymo-orchitis". Chang Gung Med J. 35 (1): 38–45. PMID 22483426.
↑ Manavi K, Turner K, Scott GR, Stewart LH (May 2005). "Audit on the management of epididymo-orchitis by the Department of Urology in Edinburgh". Int J STD AIDS. 16 (5): 386–7. doi:10.1258/0956462053888853. PMID 15949072.
↑ Lee YS, Kim SW, Han SW (2018). "Different managements for prepubertal epididymitis based on a preexisting genitourinary anomaly diagnosis". PLoS ONE. 13 (4): e0194761. doi:10.1371/journal.pone.0194761. PMC 5905873. PMID 29668706.
↑ Ralls PW, Jensen MC, Lee KP, Mayekawa DS, Johnson MB, Halls JM (June 1990). "Color Doppler sonography in acute epididymitis and orchitis". J Clin Ultrasound. 18 (5): 383–6. PMID 2161009.
↑ Michel V, Pilatz A, Hedger MP, Meinhardt A (2015). "Epididymitis: revelations at the convergence of clinical and basic sciences". Asian J. Androl. 17 (5): 756–63. doi:10.4103/1008-682X.155770. PMC 4577585. PMID 26112484.
↑ Tracy CR, Costabile RA (April 2009). "The evaluation and treatment of acute epididymitis in a large university based population: are CDC guidelines being followed?". World J Urol. 27 (2): 259–63. doi:10.1007/s00345-008-0338-0. PMID 19002691.
↑ ^7.0 ^7.1 ^7.2 Pepe P, Panella P, Pennisi M, Aragona F (October 2006). "Does color Doppler sonography improve the clinical assessment of patients with acute scrotum?". Eur J Radiol. 60 (1): 120–4. doi:10.1016/j.ejrad.2006.04.016. PMID 16730939.
↑ ^8.0 ^8.1 Ludwig M (April 2008). "Diagnosis and therapy of acute prostatitis, epididymitis and orchitis". Andrologia. 40 (2): 76–80. doi:10.1111/j.1439-0272.2007.00823.x. PMID 18336454.
↑ Davis NF, McGuire BB, Mahon JA, Smyth AE, O'Malley KJ, Fitzpatrick JM (April 2010). "The increasing incidence of mumps orchitis: a comprehensive review". BJU Int. 105 (8): 1060–5. doi:10.1111/j.1464-410X.2009.09148.x. PMID 20070300.
↑ CHARNY CW, MERANZE DR (July 1948). "Pathology of mumps orchitis". J. Urol. 60 (1): 140–6. PMID 18873054.
↑ Bjorvatn B (1973). "Mumps virus recovered from testicles by fine-needle aspiration biopsy in cases of mumps orchitis". Scand. J. Infect. Dis. 5 (1): 3–5. PMID 4580293.
↑ Beard CM, Benson RC, Kelalis PP, Elveback LR, Kurland LT (January 1977). "The incidence and outcome of mumps orchitis in Rochester, Minnesota, 1935 to 1974". Mayo Clin. Proc. 52 (1): 3–7. PMID 609284.
↑ Gall EA (July 1947). "The Histopathology of Acute Mumps Orchitis". Am. J. Pathol. 23 (4): 637–51. PMC 1934294. PMID 19970951.
↑ Başekim CC, Kizilkaya E, Pekkafali Z, Baykal KV, Karsli AF (2000). "Mumps epididymo-orchitis: sonography and color Doppler sonographic findings". Abdom Imaging. 25 (3): 322–5. PMID 10823460.
↑ Hazeltine M, Panza A, Ellsworth P (2017). "Testicular Torsion: Current Evaluation and Management". Urol Nurs. 37 (2): 61–71, 93. PMID 29240370.
↑ Estremadoyro V, Meyrat BJ, Birraux J, Vidal I, Sanchez O (February 2017). "[Diagnosis and management of testicular torsion in children]". Rev Med Suisse (in French). 13 (550): 406–410. PMID 28714632.
↑ Sharp VJ, Kieran K, Arlen AM (December 2013). "Testicular torsion: diagnosis, evaluation, and management". Am Fam Physician. 88 (12): 835–40. PMID 24364548.
↑ Mikuz G (1985). "Testicular torsion: simple grading for histological evaluation of tissue damage". Appl Pathol. 3 (3): 134–9. PMID 3842075.
↑ Gunther P, Schenk JP, Wunsch R, Holland-Cunz S, Kessler U, Troger J, Waag KL (November 2006). "Acute testicular torsion in children: the role of sonography in the diagnostic workup". Eur Radiol. 16 (11): 2527–32. doi:10.1007/s00330-006-0287-1. PMID 16724203.
↑ Bowen DK, Gonzalez CM (2014). "Intratesticular hematoma after blunt scrotal trauma: a case series and algorithm-based approach to management". Cent European J Urol. 67 (4): 427–9. doi:10.5173/ceju.2014.04.art24. PMC 4310892. PMID 25667770.
↑ Askari R, Khouzam RN, Dishmon DA (2017). "Image Diagnosis: Rapidly Enlarging Scrotal Hematoma: A Complication of Femoral Access?". Perm J. 21. doi:10.7812/TPP/16-111. PMC 5469436. PMID 28609265.
↑ Mizutani Y, Miyakawa M (February 1991). "[A case of idiopathic chronic scrotal hematocele]". Hinyokika Kiyo (in Japanese). 37 (2): 199–201. PMID 2048502.
↑ Kratzik C, Hainz A, Kuber W, Donner G, Lunglmayr G, Frick J, Schmoller HJ (November 1989). "Has ultrasound influenced the therapy concept of blunt scrotal trauma?". J. Urol. 142 (5): 1243–6. PMID 2681835.
↑ Rao MS, Arjun K (October 2012). "Sonography of scrotal trauma". Indian J Radiol Imaging. 22 (4): 293–7. doi:10.4103/0971-3026.111482. PMC 3698892. PMID 23833421.
↑ Jenkins JT, O'Dwyer PJ (2008). "Inguinal hernias". BMJ. 336 (7638): 269–72. doi:10.1136/bmj.39450.428275.AD. PMC 2223000. PMID 18244999.
↑ Berger D (2016). "Evidence-Based Hernia Treatment in Adults". Dtsch Arztebl Int. 113 (9): 150–7, quiz 158. doi:10.3238/arztebl.2016.0150. PMC 4802357. PMID 26987468.
↑ Kaya F, Kocyigit A, Kaya C, Turkcuer I, Serinken M, Karabulut N (March 2015). "Brucellar Testicular Abscess Presenting as a Testicular Mass: Can Color Doppler Sonography be used in Differentiation?". Turk J Emerg Med. 15 (1): 43–6. doi:10.5505/1304.7361.2014.82698. PMC 4909939. PMID 27331193.
↑ Navarro-Martínez A, Solera J, Corredoira J, Beato JL, Martínez-Alfaro E, Atiénzar M, Ariza J (December 2001). "Epididymoorchitis due to Brucella mellitensis: a retrospective study of 59 patients". Clin. Infect. Dis. 33 (12): 2017–22. doi:10.1086/324489. PMID 11698991.
↑ Colmenero JD, Muñoz-Roca NL, Bermudez P, Plata A, Villalobos A, Reguera JM (April 2007). "Clinical findings, diagnostic approach, and outcome of Brucella melitensis epididymo-orchitis". Diagn. Microbiol. Infect. Dis. 57 (4): 367–72. doi:10.1016/j.diagmicrobio.2006.09.008. PMID 17141451.
↑ Reisman EM, Colquitt LA, Childers J, Preminger GM (April 1990). "Brucella orchitis: a rare cause of testicular enlargement". J. Urol. 143 (4): 821–2. PMID 2313817.
↑ Rakha E, Puls F, Saidul I, Furness P (August 2006). "Torsion of the testicular appendix: importance of associated acute inflammation". J. Clin. Pathol. 59 (8): 831–4. doi:10.1136/jcp.2005.034603. PMC 1860437. PMID 16569689.
↑ Kadish HA, Bolte RG (July 1998). "A retrospective review of pediatric patients with epididymitis, testicular torsion, and torsion of testicular appendages". Pediatrics. 102 (1 Pt 1): 73–6. PMID 9651416.
↑ Okui N, Tomita K, Kimura A, Uekane K, Kawamura T, Teshima S (September 1994). "[Heterochronic occurrence of bilateral torsion of appendix testis a case report]". Nippon Hinyokika Gakkai Zasshi (in Japanese). 85 (9): 1395–8. PMID 7967303.
↑ Lev M, Ramon J, Mor Y, Jacobson JM, Soudack M (October 2015). "Sonographic appearances of torsion of the appendix testis and appendix epididymis in children". J Clin Ultrasound. 43 (8): 485–9. doi:10.1002/jcu.22265. PMID 25704247.
↑ Choong CS, Liew KL, Liu PN, Kuo TU, Su CM (July 2000). "Acute scrotum in Henoch-Schönlein purpura". Zhonghua Yi Xue Za Zhi (Taipei). 63 (7): 577–80. PMID 10934812.
↑ Modi S, Mohan M, Jennings A (May 2016). "Acute Scrotal Swelling in Henoch-Schonlein Purpura: Case Report and Review of the Literature". Urol Case Rep. 6: 9–11. doi:10.1016/j.eucr.2016.01.004. PMC 4855902. PMID 27169017.
↑ Dayanir YO, Akdilli A, Karaman CZ, Sönmez F, Karaman G (2001). "Epididymoorchitis mimicking testicular torsion in Henoch-Schönlein purpura". Eur Radiol. 11 (11): 2267–9. doi:10.1007/s003300100843. PMID 11702171.
↑ Akgun C (2012). "A case of scrotal swelling mimicking testicular torsion preceding Henoch-Schönlein vasculitis". Bratisl Lek Listy. 113 (6): 382–3. PMID 22693978.
↑ Voelzke BB, Hagedorn JC (April 2018). "Presentation and Diagnosis of Fournier Gangrene". Urology. 114: 8–13. doi:10.1016/j.urology.2017.10.031. PMID 29146218.
↑ Huang CS (March 2017). "Fournier's Gangrene". N. Engl. J. Med. 376 (12): 1158. doi:10.1056/NEJMicm1609306. PMID 28328332.
↑ Yücel M, Özpek A, Başak F, Kılıç A, Ünal E, Yüksekdağ S, Acar A, Baş G (September 2017). "Fournier's gangrene: A retrospective analysis of 25 patients". Ulus Travma Acil Cerrahi Derg. 23 (5): 400–404. doi:10.5505/tjtes.2017.01678. PMID 29052826.
↑ Namkoong H, Ishii M, Koizumi M, Betsuyaku T (February 2016). "Fournier's gangrene: a surgical emergency". Infection. 44 (1): 143–4. doi:10.1007/s15010-015-0816-4. PMID 26138056.
↑ Hagerman RJ, McBogg P, Hagerman PJ (June 1983). "The fragile X syndrome: history, diagnosis, and treatment". J Dev Behav Pediatr. 4 (2): 122–30. PMID 6348096.
↑ de Vries BB, Halley DJ, Oostra BA, Niermeijer MF (July 1998). "The fragile X syndrome". J. Med. Genet. 35 (7): 579–89. PMC 1051369. PMID 9678703.
↑ Lachiewicz AM, Dawson DV (June 1994). "Do young boys with fragile X syndrome have macroorchidism?". Pediatrics. 93 (6 Pt 1): 992–5. PMID 8190590.
↑ Saldarriaga W, Tassone F, González-Teshima LY, Forero-Forero JV, Ayala-Zapata S, Hagerman R (2014). "Fragile X syndrome". Colomb. Med. 45 (4): 190–8. PMC 4350386. PMID 25767309.
↑ Shen J, Bi Y, Wang X, Lu L, Tang L, Liu Y, Chen H, Zhang B (December 2017). "Epidemiologic study of 230 cases of testicular/paratesticular tumors or masses: 15-year experience of a single center". J. Pediatr. Surg. 52 (12): 2056–2060. doi:10.1016/j.jpedsurg.2017.08.027. PMID 28967388.
↑ Hohšteter M, Artuković B, Severin K, Kurilj AG, Beck A, Šoštarić-Zuckermann IC, Grabarević Ž (August 2014). "Canine testicular tumors: two types of seminomas can be differentiated by immunohistochemistry". BMC Vet. Res. 10: 169. doi:10.1186/s12917-014-0169-8. PMC 4129470. PMID 25096628.
↑ McDonald MW, Reed AB, Tran PT, Evans LA (2012). "Testicular tumor ultrasound characteristics and association with histopathology". Urol. Int. 89 (2): 196–202. doi:10.1159/000338771. PMID 22677786.
↑ Naouar S, Braiek S, El Kamel R (June 2017). "Testicular tumors of adrenogenital syndrome: From physiopathology to therapy". Presse Med. 46 (6 Pt 1): 572–578. doi:10.1016/j.lpm.2017.05.006. PMID 28549629.
↑ Costantino E, Ganesan GS, Plaire JC (May 2017). "Abdominoscrotal hydrocele in an infant boy". BMJ Case Rep. 2017. doi:10.1136/bcr-2017-220370. PMID 28551604.
↑ Kaefer M, Agarwal D, Misseri R, Whittam B, Hubert K, Szymanski K, Rink R, Cain MP (October 2016). "Treatment of contralateral hydrocele in neonatal testicular torsion: Is less more?". J Pediatr Urol. 12 (5): 306.e1–306.e4. doi:10.1016/j.jpurol.2015.07.009. PMID 26708803.
↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.
↑ Chen Y, Wang F, Zhong H, Zhao J, Li Y, Shi Z (December 2017). "A systematic review and meta-analysis concerning single-site laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia and hydrocele". Surg Endosc. 31 (12): 4888–4901. doi:10.1007/s00464-017-5491-3. PMID 28389795.
↑ ^55.0 ^55.1 Rioja J, Sánchez-Margallo FM, Usón J, Rioja LA (June 2011). "Adult hydrocele and spermatocele". BJU Int. 107 (11): 1852–64. doi:10.1111/j.1464-410X.2011.10353.x. PMID 21592287.
↑ Clavijo RI, Carrasquillo R, Ramasamy R (September 2017). "Varicoceles: prevalence and pathogenesis in adult men". Fertil. Steril. 108 (3): 364–369. doi:10.1016/j.fertnstert.2017.06.036. PMID 28865534.
↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.
↑ Locke JA, Noparast M, Afshar K (October 2017). "Treatment of varicocele in children and adolescents: A systematic review and meta-analysis of randomized controlled trials". J Pediatr Urol. 13 (5): 437–445. doi:10.1016/j.jpurol.2017.07.008. PMID 28851509.
↑ Shridharani A, Owen RC, Elkelany OO, Kim ED (2016). "The significance of clinical practice guidelines on adult varicocele detection and management". Asian J. Androl. 18 (2): 269–75. doi:10.4103/1008-682X.172641. PMID 26806081.
↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.
↑ Yeh HC, Wang CJ, Liu CC, Wu WJ, Chou YH, Huang CH (July 2007). "Giant spermatocele mimicking hydrocele: a case report". Kaohsiung J. Med. Sci. 23 (7): 366–9. doi:10.1016/S1607-551X(09)70423-1. PMID 17606432.
↑ Geffre M, Maki C, Maier S (March 2017). "Acute Scrotal Edema in Cirrhotic after Laparoscopic Cholecystectomy". Am Surg. 83 (3): e93–95. PMID 28316300.
↑ Esposito F, Sanchez O, Siebert JN, Manzano S (October 2018). "Acute scrotal idiopathic edema: A misleading erythema". CJEM. 20 (S2): S37. doi:10.1017/cem.2017.343. PMID 28625172.
↑ Solanki A, Narang S, Kathpalia R, Goel A (September 2015). "Scrotal calcinosis: pathogenetic link with epidermal cyst". BMJ Case Rep. 2015. doi:10.1136/bcr-2015-211163. PMC 4593290. PMID 26400592.
↑ Prasad KK, Manjunath RD (August 2014). "Multiple epidermal cysts of scrotum". Indian J. Med. Res. 140 (2): 318. PMC 4216510. PMID 25297369.
↑ Ząbkowski T, Wajszczuk M (July 2014). "Epidermoid cyst of the scrotum: a clinical case". Urol J. 11 (3): 1706–9. PMID 25015622.
↑ Casasola Chamorro J, Gutiérrez García S, de Blas Gómez V (July 2011). "Scrotal carcinoma". Arch. Esp. Urol. 64 (6): 541–3. PMID 21791720.
↑ Halfya A, Elmortaji K, Redouane R, Fethi M, Rafik A, Mohamed E, Abdessamad C (2015). "[Squamous cell carcinomas of the scrotum: about 7 cases with review of the literature]". Pan Afr Med J (in French). 20: 163. doi:10.11604/pamj.2015.20.163.5991. PMC 4469445. PMID 26113906.
↑ Armas-Alvarez AL, Salinas-Sánchez AS, Atienzar-Tobarra M, Virseda-Rodríguez JA (March 2016). "Scrotal tumors". Arch. Esp. Urol. 69 (2): 86–9. PMID 26959967.
↑ Otabil KB, Tenkorang SB (March 2015). "Filarial hydrocele: a neglected condition of a neglected tropical disease". J Infect Dev Ctries. 9 (5): 456–62. doi:10.3855/jidc.5346. PMID 25989164.
↑ Janssen KM, Willis CJ, Anderson M, Gelnett MS, Wickersham EL, Brand TC (July 2017). "Filariasis Orchitis-Differential for Acute Scrotum Pathology". Urol Case Rep. 13: 117–119. doi:10.1016/j.eucr.2017.04.002. PMC 5426035. PMID 28507911.
↑ Yagain K, Mathew M (February 2011). "Filariasis presenting as a scrotal nodule in a 2 year old child: a case report". Asian Pac J Trop Med. 4 (2): 167–8. doi:10.1016/S1995-7645(11)60062-X. PMID 21771446.
↑ Khallouk A, Yazami OE, Mellas S, Tazi MF, El Fassi J, Farih MH (2011). "Idiopathic scrotal calcinosis: a non-elucidated pathogenesis and its surgical treatment". Rev Urol. 13 (2): 95–7. PMC 3176555. PMID 21935341.
↑ Noël B, Bron C, Künzle N, De Heller M, Panizzon RG (July 2006). "Multiple nodules of the scrotum: histopathological findings and surgical procedure. A study of five cases". J Eur Acad Dermatol Venereol. 20 (6): 707–10. doi:10.1111/j.1468-3083.2006.01578.x. PMID 16836500.
↑ Polk P, McCutchen WT, Phillips JG, Biggs PJ (September 1996). "Polypoid scrotal calcinosis: an uncommon variant of scrotal calcinosis". South. Med. J. 89 (9): 896–7. PMID 8790314.

[pmid22483426-1] Yu KJ, Wang TM, Chen HW, Wang HH (2012). "The dilemma in the diagnosis of acute scrotum: clinical clues for differentiating between testicular torsion and epididymo-orchitis". Chang Gung Med J. 35 (1): 38–45. PMID 22483426.

[pmid15949072-2] Manavi K, Turner K, Scott GR, Stewart LH (May 2005). "Audit on the management of epididymo-orchitis by the Department of Urology in Edinburgh". Int J STD AIDS. 16 (5): 386–7. doi:10.1258/0956462053888853. PMID 15949072.

[pmid29668706-3] Lee YS, Kim SW, Han SW (2018). "Different managements for prepubertal epididymitis based on a preexisting genitourinary anomaly diagnosis". PLoS ONE. 13 (4): e0194761. doi:10.1371/journal.pone.0194761. PMC 5905873. PMID 29668706.

[pmid2161009-4] Ralls PW, Jensen MC, Lee KP, Mayekawa DS, Johnson MB, Halls JM (June 1990). "Color Doppler sonography in acute epididymitis and orchitis". J Clin Ultrasound. 18 (5): 383–6. PMID 2161009.

[pmid26112484-5] Michel V, Pilatz A, Hedger MP, Meinhardt A (2015). "Epididymitis: revelations at the convergence of clinical and basic sciences". Asian J. Androl. 17 (5): 756–63. doi:10.4103/1008-682X.155770. PMC 4577585. PMID 26112484.

[pmid19002691-6] Tracy CR, Costabile RA (April 2009). "The evaluation and treatment of acute epididymitis in a large university based population: are CDC guidelines being followed?". World J Urol. 27 (2): 259–63. doi:10.1007/s00345-008-0338-0. PMID 19002691.

[pmid16730939-7] 7.0 ^7.1 ^7.2 Pepe P, Panella P, Pennisi M, Aragona F (October 2006). "Does color Doppler sonography improve the clinical assessment of patients with acute scrotum?". Eur J Radiol. 60 (1): 120–4. doi:10.1016/j.ejrad.2006.04.016. PMID 16730939.

[pmid18336454-8] 8.0 ^8.1 Ludwig M (April 2008). "Diagnosis and therapy of acute prostatitis, epididymitis and orchitis". Andrologia. 40 (2): 76–80. doi:10.1111/j.1439-0272.2007.00823.x. PMID 18336454.

[pmid20070300-9] Davis NF, McGuire BB, Mahon JA, Smyth AE, O'Malley KJ, Fitzpatrick JM (April 2010). "The increasing incidence of mumps orchitis: a comprehensive review". BJU Int. 105 (8): 1060–5. doi:10.1111/j.1464-410X.2009.09148.x. PMID 20070300.

[pmid18873054-10] CHARNY CW, MERANZE DR (July 1948). "Pathology of mumps orchitis". J. Urol. 60 (1): 140–6. PMID 18873054.

[pmid4580293-11] Bjorvatn B (1973). "Mumps virus recovered from testicles by fine-needle aspiration biopsy in cases of mumps orchitis". Scand. J. Infect. Dis. 5 (1): 3–5. PMID 4580293.

[pmid609284-12] Beard CM, Benson RC, Kelalis PP, Elveback LR, Kurland LT (January 1977). "The incidence and outcome of mumps orchitis in Rochester, Minnesota, 1935 to 1974". Mayo Clin. Proc. 52 (1): 3–7. PMID 609284.

[pmid19970951-13] Gall EA (July 1947). "The Histopathology of Acute Mumps Orchitis". Am. J. Pathol. 23 (4): 637–51. PMC 1934294. PMID 19970951.

[pmid10823460-14] Başekim CC, Kizilkaya E, Pekkafali Z, Baykal KV, Karsli AF (2000). "Mumps epididymo-orchitis: sonography and color Doppler sonographic findings". Abdom Imaging. 25 (3): 322–5. PMID 10823460.

[pmid29240370-15] Hazeltine M, Panza A, Ellsworth P (2017). "Testicular Torsion: Current Evaluation and Management". Urol Nurs. 37 (2): 61–71, 93. PMID 29240370.

[pmid28714632-16] Estremadoyro V, Meyrat BJ, Birraux J, Vidal I, Sanchez O (February 2017). "[Diagnosis and management of testicular torsion in children]". Rev Med Suisse (in French). 13 (550): 406–410. PMID 28714632.

[pmid24364548-17] Sharp VJ, Kieran K, Arlen AM (December 2013). "Testicular torsion: diagnosis, evaluation, and management". Am Fam Physician. 88 (12): 835–40. PMID 24364548.

[pmid3842075-18] Mikuz G (1985). "Testicular torsion: simple grading for histological evaluation of tissue damage". Appl Pathol. 3 (3): 134–9. PMID 3842075.

[pmid16724203-19] Gunther P, Schenk JP, Wunsch R, Holland-Cunz S, Kessler U, Troger J, Waag KL (November 2006). "Acute testicular torsion in children: the role of sonography in the diagnostic workup". Eur Radiol. 16 (11): 2527–32. doi:10.1007/s00330-006-0287-1. PMID 16724203.

[pmid25667770-20] Bowen DK, Gonzalez CM (2014). "Intratesticular hematoma after blunt scrotal trauma: a case series and algorithm-based approach to management". Cent European J Urol. 67 (4): 427–9. doi:10.5173/ceju.2014.04.art24. PMC 4310892. PMID 25667770.

[pmid28609265-21] Askari R, Khouzam RN, Dishmon DA (2017). "Image Diagnosis: Rapidly Enlarging Scrotal Hematoma: A Complication of Femoral Access?". Perm J. 21. doi:10.7812/TPP/16-111. PMC 5469436. PMID 28609265.

[pmid2048502-22] Mizutani Y, Miyakawa M (February 1991). "[A case of idiopathic chronic scrotal hematocele]". Hinyokika Kiyo (in Japanese). 37 (2): 199–201. PMID 2048502.

[pmid2681835-23] Kratzik C, Hainz A, Kuber W, Donner G, Lunglmayr G, Frick J, Schmoller HJ (November 1989). "Has ultrasound influenced the therapy concept of blunt scrotal trauma?". J. Urol. 142 (5): 1243–6. PMID 2681835.

[pmid23833421-24] Rao MS, Arjun K (October 2012). "Sonography of scrotal trauma". Indian J Radiol Imaging. 22 (4): 293–7. doi:10.4103/0971-3026.111482. PMC 3698892. PMID 23833421.

[pmid18244999-25] Jenkins JT, O'Dwyer PJ (2008). "Inguinal hernias". BMJ. 336 (7638): 269–72. doi:10.1136/bmj.39450.428275.AD. PMC 2223000. PMID 18244999.

[pmid26987468-26] Berger D (2016). "Evidence-Based Hernia Treatment in Adults". Dtsch Arztebl Int. 113 (9): 150–7, quiz 158. doi:10.3238/arztebl.2016.0150. PMC 4802357. PMID 26987468.

[pmid27331193-27] Kaya F, Kocyigit A, Kaya C, Turkcuer I, Serinken M, Karabulut N (March 2015). "Brucellar Testicular Abscess Presenting as a Testicular Mass: Can Color Doppler Sonography be used in Differentiation?". Turk J Emerg Med. 15 (1): 43–6. doi:10.5505/1304.7361.2014.82698. PMC 4909939. PMID 27331193.

[pmid11698991-28] Navarro-Martínez A, Solera J, Corredoira J, Beato JL, Martínez-Alfaro E, Atiénzar M, Ariza J (December 2001). "Epididymoorchitis due to Brucella mellitensis: a retrospective study of 59 patients". Clin. Infect. Dis. 33 (12): 2017–22. doi:10.1086/324489. PMID 11698991.

[pmid17141451-29] Colmenero JD, Muñoz-Roca NL, Bermudez P, Plata A, Villalobos A, Reguera JM (April 2007). "Clinical findings, diagnostic approach, and outcome of Brucella melitensis epididymo-orchitis". Diagn. Microbiol. Infect. Dis. 57 (4): 367–72. doi:10.1016/j.diagmicrobio.2006.09.008. PMID 17141451.

[pmid2313817-30] Reisman EM, Colquitt LA, Childers J, Preminger GM (April 1990). "Brucella orchitis: a rare cause of testicular enlargement". J. Urol. 143 (4): 821–2. PMID 2313817.

[pmid16569689-31] Rakha E, Puls F, Saidul I, Furness P (August 2006). "Torsion of the testicular appendix: importance of associated acute inflammation". J. Clin. Pathol. 59 (8): 831–4. doi:10.1136/jcp.2005.034603. PMC 1860437. PMID 16569689.

[pmid9651416-32] Kadish HA, Bolte RG (July 1998). "A retrospective review of pediatric patients with epididymitis, testicular torsion, and torsion of testicular appendages". Pediatrics. 102 (1 Pt 1): 73–6. PMID 9651416.

[pmid7967303-33] Okui N, Tomita K, Kimura A, Uekane K, Kawamura T, Teshima S (September 1994). "[Heterochronic occurrence of bilateral torsion of appendix testis a case report]". Nippon Hinyokika Gakkai Zasshi (in Japanese). 85 (9): 1395–8. PMID 7967303.

[pmid25704247-34] Lev M, Ramon J, Mor Y, Jacobson JM, Soudack M (October 2015). "Sonographic appearances of torsion of the appendix testis and appendix epididymis in children". J Clin Ultrasound. 43 (8): 485–9. doi:10.1002/jcu.22265. PMID 25704247.

[pmid10934812-35] Choong CS, Liew KL, Liu PN, Kuo TU, Su CM (July 2000). "Acute scrotum in Henoch-Schönlein purpura". Zhonghua Yi Xue Za Zhi (Taipei). 63 (7): 577–80. PMID 10934812.

[pmid27169017-36] Modi S, Mohan M, Jennings A (May 2016). "Acute Scrotal Swelling in Henoch-Schonlein Purpura: Case Report and Review of the Literature". Urol Case Rep. 6: 9–11. doi:10.1016/j.eucr.2016.01.004. PMC 4855902. PMID 27169017.

[pmid11702171-37] Dayanir YO, Akdilli A, Karaman CZ, Sönmez F, Karaman G (2001). "Epididymoorchitis mimicking testicular torsion in Henoch-Schönlein purpura". Eur Radiol. 11 (11): 2267–9. doi:10.1007/s003300100843. PMID 11702171.

[pmid22693978-38] Akgun C (2012). "A case of scrotal swelling mimicking testicular torsion preceding Henoch-Schönlein vasculitis". Bratisl Lek Listy. 113 (6): 382–3. PMID 22693978.

[pmid29146218-39] Voelzke BB, Hagedorn JC (April 2018). "Presentation and Diagnosis of Fournier Gangrene". Urology. 114: 8–13. doi:10.1016/j.urology.2017.10.031. PMID 29146218.

[pmid28328332-40] Huang CS (March 2017). "Fournier's Gangrene". N. Engl. J. Med. 376 (12): 1158. doi:10.1056/NEJMicm1609306. PMID 28328332.

[pmid29052826-41] Yücel M, Özpek A, Başak F, Kılıç A, Ünal E, Yüksekdağ S, Acar A, Baş G (September 2017). "Fournier's gangrene: A retrospective analysis of 25 patients". Ulus Travma Acil Cerrahi Derg. 23 (5): 400–404. doi:10.5505/tjtes.2017.01678. PMID 29052826.

[pmid26138056-42] Namkoong H, Ishii M, Koizumi M, Betsuyaku T (February 2016). "Fournier's gangrene: a surgical emergency". Infection. 44 (1): 143–4. doi:10.1007/s15010-015-0816-4. PMID 26138056.

[pmid6348096-43] Hagerman RJ, McBogg P, Hagerman PJ (June 1983). "The fragile X syndrome: history, diagnosis, and treatment". J Dev Behav Pediatr. 4 (2): 122–30. PMID 6348096.

[pmid9678703-44] Vries BB, Halley DJ, Oostra BA, Niermeijer MF (July 1998). "The fragile X syndrome". J. Med. Genet. 35 (7): 579–89. PMC 1051369. PMID 9678703.

[pmid8190590-45] Lachiewicz AM, Dawson DV (June 1994). "Do young boys with fragile X syndrome have macroorchidism?". Pediatrics. 93 (6 Pt 1): 992–5. PMID 8190590.

[pmid25767309-46] Saldarriaga W, Tassone F, González-Teshima LY, Forero-Forero JV, Ayala-Zapata S, Hagerman R (2014). "Fragile X syndrome". Colomb. Med. 45 (4): 190–8. PMC 4350386. PMID 25767309.

[pmid28967388-47] Shen J, Bi Y, Wang X, Lu L, Tang L, Liu Y, Chen H, Zhang B (December 2017). "Epidemiologic study of 230 cases of testicular/paratesticular tumors or masses: 15-year experience of a single center". J. Pediatr. Surg. 52 (12): 2056–2060. doi:10.1016/j.jpedsurg.2017.08.027. PMID 28967388.

[pmid25096628-48] Hohšteter M, Artuković B, Severin K, Kurilj AG, Beck A, Šoštarić-Zuckermann IC, Grabarević Ž (August 2014). "Canine testicular tumors: two types of seminomas can be differentiated by immunohistochemistry". BMC Vet. Res. 10: 169. doi:10.1186/s12917-014-0169-8. PMC 4129470. PMID 25096628.

[pmid22677786-49] McDonald MW, Reed AB, Tran PT, Evans LA (2012). "Testicular tumor ultrasound characteristics and association with histopathology". Urol. Int. 89 (2): 196–202. doi:10.1159/000338771. PMID 22677786.

[pmid28549629-50] Naouar S, Braiek S, El Kamel R (June 2017). "Testicular tumors of adrenogenital syndrome: From physiopathology to therapy". Presse Med. 46 (6 Pt 1): 572–578. doi:10.1016/j.lpm.2017.05.006. PMID 28549629.

[pmid28551604-51] Costantino E, Ganesan GS, Plaire JC (May 2017). "Abdominoscrotal hydrocele in an infant boy". BMJ Case Rep. 2017. doi:10.1136/bcr-2017-220370. PMID 28551604.

[pmid26708803-52] Kaefer M, Agarwal D, Misseri R, Whittam B, Hubert K, Szymanski K, Rink R, Cain MP (October 2016). "Treatment of contralateral hydrocele in neonatal testicular torsion: Is less more?". J Pediatr Urol. 12 (5): 306.e1–306.e4. doi:10.1016/j.jpurol.2015.07.009. PMID 26708803.

[pmid174600034-53] Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.

[pmid28389795-54] Chen Y, Wang F, Zhong H, Zhao J, Li Y, Shi Z (December 2017). "A systematic review and meta-analysis concerning single-site laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia and hydrocele". Surg Endosc. 31 (12): 4888–4901. doi:10.1007/s00464-017-5491-3. PMID 28389795.

[pmid21592287-55] 55.0 ^55.1 Rioja J, Sánchez-Margallo FM, Usón J, Rioja LA (June 2011). "Adult hydrocele and spermatocele". BJU Int. 107 (11): 1852–64. doi:10.1111/j.1464-410X.2011.10353.x. PMID 21592287.

[pmid28865534-56] Clavijo RI, Carrasquillo R, Ramasamy R (September 2017). "Varicoceles: prevalence and pathogenesis in adult men". Fertil. Steril. 108 (3): 364–369. doi:10.1016/j.fertnstert.2017.06.036. PMID 28865534.

[pmid174600033-57] Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.

[pmid28851509-58] Locke JA, Noparast M, Afshar K (October 2017). "Treatment of varicocele in children and adolescents: A systematic review and meta-analysis of randomized controlled trials". J Pediatr Urol. 13 (5): 437–445. doi:10.1016/j.jpurol.2017.07.008. PMID 28851509.

[pmid26806081-59] Shridharani A, Owen RC, Elkelany OO, Kim ED (2016). "The significance of clinical practice guidelines on adult varicocele detection and management". Asian J. Androl. 18 (2): 269–75. doi:10.4103/1008-682X.172641. PMID 26806081.

[pmid174600032-60] Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.

[pmid17606432-61] Yeh HC, Wang CJ, Liu CC, Wu WJ, Chou YH, Huang CH (July 2007). "Giant spermatocele mimicking hydrocele: a case report". Kaohsiung J. Med. Sci. 23 (7): 366–9. doi:10.1016/S1607-551X(09)70423-1. PMID 17606432.

[pmid28316300-62] Geffre M, Maki C, Maier S (March 2017). "Acute Scrotal Edema in Cirrhotic after Laparoscopic Cholecystectomy". Am Surg. 83 (3): e93–95. PMID 28316300.

[pmid28625172-63] Esposito F, Sanchez O, Siebert JN, Manzano S (October 2018). "Acute scrotal idiopathic edema: A misleading erythema". CJEM. 20 (S2): S37. doi:10.1017/cem.2017.343. PMID 28625172.

[pmid26400592-64] Solanki A, Narang S, Kathpalia R, Goel A (September 2015). "Scrotal calcinosis: pathogenetic link with epidermal cyst". BMJ Case Rep. 2015. doi:10.1136/bcr-2015-211163. PMC 4593290. PMID 26400592.

[pmid25297369-65] Prasad KK, Manjunath RD (August 2014). "Multiple epidermal cysts of scrotum". Indian J. Med. Res. 140 (2): 318. PMC 4216510. PMID 25297369.

[pmid25015622-66] Ząbkowski T, Wajszczuk M (July 2014). "Epidermoid cyst of the scrotum: a clinical case". Urol J. 11 (3): 1706–9. PMID 25015622.

[pmid21791720-67] Casasola Chamorro J, Gutiérrez García S, de Blas Gómez V (July 2011). "Scrotal carcinoma". Arch. Esp. Urol. 64 (6): 541–3. PMID 21791720.

[pmid26113906-68] Halfya A, Elmortaji K, Redouane R, Fethi M, Rafik A, Mohamed E, Abdessamad C (2015). "[Squamous cell carcinomas of the scrotum: about 7 cases with review of the literature]". Pan Afr Med J (in French). 20: 163. doi:10.11604/pamj.2015.20.163.5991. PMC 4469445. PMID 26113906.

[pmid26959967-69] Armas-Alvarez AL, Salinas-Sánchez AS, Atienzar-Tobarra M, Virseda-Rodríguez JA (March 2016). "Scrotal tumors". Arch. Esp. Urol. 69 (2): 86–9. PMID 26959967.

[pmid25989164-70] Otabil KB, Tenkorang SB (March 2015). "Filarial hydrocele: a neglected condition of a neglected tropical disease". J Infect Dev Ctries. 9 (5): 456–62. doi:10.3855/jidc.5346. PMID 25989164.

[pmid28507911-71] Janssen KM, Willis CJ, Anderson M, Gelnett MS, Wickersham EL, Brand TC (July 2017). "Filariasis Orchitis-Differential for Acute Scrotum Pathology". Urol Case Rep. 13: 117–119. doi:10.1016/j.eucr.2017.04.002. PMC 5426035. PMID 28507911.

[pmid21771446-72] Yagain K, Mathew M (February 2011). "Filariasis presenting as a scrotal nodule in a 2 year old child: a case report". Asian Pac J Trop Med. 4 (2): 167–8. doi:10.1016/S1995-7645(11)60062-X. PMID 21771446.

[pmid21935341-73] Khallouk A, Yazami OE, Mellas S, Tazi MF, El Fassi J, Farih MH (2011). "Idiopathic scrotal calcinosis: a non-elucidated pathogenesis and its surgical treatment". Rev Urol. 13 (2): 95–7. PMC 3176555. PMID 21935341.

[pmid16836500-74] Noël B, Bron C, Künzle N, De Heller M, Panizzon RG (July 2006). "Multiple nodules of the scrotum: histopathological findings and surgical procedure. A study of five cases". J Eur Acad Dermatol Venereol. 20 (6): 707–10. doi:10.1111/j.1468-3083.2006.01578.x. PMID 16836500.

[pmid8790314-75] Polk P, McCutchen WT, Phillips JG, Biggs PJ (September 1996). "Polypoid scrotal calcinosis: an uncommon variant of scrotal calcinosis". South. Med. J. 89 (9): 896–7. PMID 8790314.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

[23]

[24]

[25]

[26]

[27]

[28]

[29]

[30]

[31]

[32]

[33]

[34]

[35]

[36]

[37]

[38]

[39]

[40]

[41]

[42]

[43]

[44]

[45]

[46]

[47]

[48]

[49]

[50]

[51]

[52]

[53]

[54]

[55]

[56]

[57]

[58]

[59]

[60]

[61]

[62]

[63]

[64]

[65]

[66]

[67]

[68]

[69]

[70]

[71]

[72]

[73]

[74]

[75]

@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Scrotal mass}}
+[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Scrotal_mass]]
-{{CMG}}{{AE}}{{Preeti}}
+{{CMG}};{{AE}}{{NE}}{{Preeti}}
 ==Overview==
-Scrotal masses may be differentiated according to clinical features, laboratory findings, imaging features, histological features, and genetic studies from other diseases that cause testicular mass with discomfort, [[back pain]], [[abdominal discomfort]], or [[abdominal mass]]. Common differential diagnoses include [[yolk sac tumor]], [[teratoma]], [[choriocarcinoma]], [[embryonal cell carcinoma]], [[seminoma]], and [[lymphoma|testicular lymphoma]] (usually [[non-Hodgkin lymphoma]]).
+Scrotal masses must be differentiated from other diseases that cause scrotal swelling,scrotal pain,such as testicular tortion ,epididimitis,testicular tumors,inguinal herniation and many other diseases.
-==Differential Diagnosis==
+==Differentiating Scrotal masses from the other Diseases==
-The table below summarizes the findings that differentiates scrotal mass according to the clinical features, laboratory findings, imaging features, histological features, and genetic studies.
+[[Scrotal mass|Scrotal masses]] must be differentiated from other diseases that cause scrotal swelling,scrotal pain,such as [[Testicular cancer|testicular tortion]] ,[[Epidemic abscess|epididimitis,]]<nowiki/>testicular tumors,[[Inguinal canal|inguinal herniation]] and many other diseases.
+*The table below summarizes the findings that differentiates [[Scrotal mass (patient information)|scrotal mass]] according to the clinical features, laboratory findings, imaging features, [[Histological section|histological features]], and [[genetic]] studies.
 {|
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-!Scrotal Swelling
 ! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
 | colspan="9" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
@@ Line 18: / Line 19: @@
 ! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated
 |-
-| rowspan="12" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Painful
 | colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
 ! colspan="5" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
@@ Line 30: / Line 30: @@
 ! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinary symptoms
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenderness
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tender<br>-ness
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Erythema
 ! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Discharge
@@ Line 37: / Line 37: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood/Urine Analysis
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Doppler U/S
+|-
+! colspan="16" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |Painful
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Epididymoorchitis|Epididymitis]]<ref name="pmid22483426">{{cite journal |vauthors=Yu KJ, Wang TM, Chen HW, Wang HH |title=The dilemma in the diagnosis of acute scrotum: clinical clues for differentiating between testicular torsion and epididymo-orchitis |journal=Chang Gung Med J |volume=35 |issue=1 |pages=38–45 |date=2012 |pmid=22483426 |doi= |url=}}</ref><ref name="pmid15949072">{{cite journal |vauthors=Manavi K, Turner K, Scott GR, Stewart LH |title=Audit on the management of epididymo-orchitis by the Department of Urology in Edinburgh |journal=Int J STD AIDS |volume=16 |issue=5 |pages=386–7 |date=May 2005 |pmid=15949072 |doi=10.1258/0956462053888853 |url=}}</ref><br><ref name="pmid29668706">{{cite journal |vauthors=Lee YS, Kim SW, Han SW |title=Different managements for prepubertal epididymitis based on a preexisting genitourinary anomaly diagnosis |journal=PLoS ONE |volume=13 |issue=4 |pages=e0194761 |date=2018 |pmid=29668706 |pmc=5905873 |doi=10.1371/journal.pone.0194761 |url=}}</ref><ref name="pmid2161009">{{cite journal |vauthors=Ralls PW, Jensen MC, Lee KP, Mayekawa DS, Johnson MB, Halls JM |title=Color Doppler sonography in acute epididymitis and orchitis |journal=J Clin Ultrasound |volume=18 |issue=5 |pages=383–6 |date=June 1990 |pmid=2161009 |doi= |url=}}</ref><ref name="pmid26112484">{{cite journal |vauthors=Michel V, Pilatz A, Hedger MP, Meinhardt A |title=Epididymitis: revelations at the convergence of clinical and basic sciences |journal=Asian J. Androl. |volume=17 |issue=5 |pages=756–63 |date=2015 |pmid=26112484 |pmc=4577585 |doi=10.4103/1008-682X.155770 |url=}}</ref><ref name="pmid19002691">{{cite journal |vauthors=Tracy CR, Costabile RA |title=The evaluation and treatment of acute epididymitis in a large university based population: are CDC guidelines being followed? |journal=World J Urol |volume=27 |issue=2 |pages=259–63 |date=April 2009 |pmid=19002691 |doi=10.1007/s00345-008-0338-0 |url=}}</ref><ref name="pmid16730939">{{cite journal |vauthors=Pepe P, Panella P, Pennisi M, Aragona F |title=Does color Doppler sonography improve the clinical assessment of patients with acute scrotum? |journal=Eur J Radiol |volume=60 |issue=1 |pages=120–4 |date=October 2006 |pmid=16730939 |doi=10.1016/j.ejrad.2006.04.016 |url=}}</ref><ref name="pmid18336454">{{cite journal |vauthors=Ludwig M |title=Diagnosis and therapy of acute prostatitis, epididymitis and orchitis |journal=Andrologia |volume=40 |issue=2 |pages=76–80 |date=April 2008 |pmid=18336454 |doi=10.1111/j.1439-0272.2007.00823.x |url=}}</ref>
@@ Line 45: / Line 47: @@
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px;" |Pyuria
+| style="background: #F5F5F5; padding: 5px;" | +
-Bacteriuria
+(Pyuria
+Bacteriuria)
 | style="background: #F5F5F5; padding: 5px;" |Painful local lymphadenopathy
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
@@ Line 64: / Line 67: @@
 * [[Ultrasound]] for diagnosis ([[Testicular masses]]<nowiki/>or swollen [[testicles]] with hypoechoic and hypervascular areas)
 | style="background: #F5F5F5; padding: 5px;" |
-** [[Hydrocele]]
+* [[Hydrocele]]
-** [[Urinary tract infection]]
+* [[Urinary tract infection]]
-** Gonococcal infection
+* Gonococcal infection
-** chlamydia infection
+* chlamydia infection
-** Phen sign +ve
+* Phen sign +ve
-| style="background: #F5F5F5; padding: 5px;" |
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Orchitis]]
@@ Line 108: / Line 110: @@
 | style="background: #F5F5F5; padding: 5px;" |Sudden
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |Absent
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |Blood in semen may be present
+| style="background: #F5F5F5; padding: 5px;" | +
+Blood in semen may be present
 | style="background: #F5F5F5; padding: 5px;" |Absent
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px;" |Normal
+| style="background: #F5F5F5; padding: 5px;" |
+* Normal
 | style="background: #F5F5F5; padding: 5px;" |
 * Absent or decreased arterial perfusion of the testis
@@ Line 129: / Line 133: @@
 | style="background: #F5F5F5; padding: 5px;" |
 * [[Doppler ultrasound]]> [[Computed tomography|CT scan]]
-| style="background: #F5F5F5; padding: 5px;" |Phen sign +ve
+| style="background: #F5F5F5; padding: 5px;" |
+* Phen sign +ve
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hematocele]]<ref name="pmid25667770">{{cite journal |vauthors=Bowen DK, Gonzalez CM |title=Intratesticular hematoma after blunt scrotal trauma: a case series and algorithm-based approach to management |journal=Cent European J Urol |volume=67 |issue=4 |pages=427–9 |date=2014 |pmid=25667770 |pmc=4310892 |doi=10.5173/ceju.2014.04.art24 |url=}}</ref><ref name="pmid28609265">{{cite journal |vauthors=Askari R, Khouzam RN, Dishmon DA |title=Image Diagnosis: Rapidly Enlarging Scrotal Hematoma: A Complication of Femoral Access? |journal=Perm J |volume=21 |issue= |pages= |date=2017 |pmid=28609265 |pmc=5469436 |doi=10.7812/TPP/16-111 |url=}}</ref><br><ref name="pmid2048502">{{cite journal |vauthors=Mizutani Y, Miyakawa M |title=[A case of idiopathic chronic scrotal hematocele] |language=Japanese |journal=Hinyokika Kiyo |volume=37 |issue=2 |pages=199–201 |date=February 1991 |pmid=2048502 |doi= |url=}}</ref><ref name="pmid2681835">{{cite journal |vauthors=Kratzik C, Hainz A, Kuber W, Donner G, Lunglmayr G, Frick J, Schmoller HJ |title=Has ultrasound influenced the therapy concept of blunt scrotal trauma? |journal=J. Urol. |volume=142 |issue=5 |pages=1243–6 |date=November 1989 |pmid=2681835 |doi= |url=}}</ref><ref name="pmid23833421">{{cite journal |vauthors=Rao MS, Arjun K |title=Sonography of scrotal trauma |journal=Indian J Radiol Imaging |volume=22 |issue=4 |pages=293–7 |date=October 2012 |pmid=23833421 |pmc=3698892 |doi=10.4103/0971-3026.111482 |url=}}</ref>
@@ Line 135: / Line 140: @@
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Sudden
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>+</nowiki>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>+</nowiki>
-| style="background: #F5F5F5; padding: 5px; " |Blood in semen
+| style="background: #F5F5F5; padding: 5px; " | +
+Blood in semen
 | style="background: #F5F5F5; padding: 5px; " |Absent
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Urinalysis  may be the only indication of injury to urinary tract
+* [[Hematuria]].
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Scrotal wall thickening and testicular hematoma
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Testicular trauma related to:
+* Sports injuries.
+* Direct [[trauma]]
+* Motor vehicle accidents
+* [[Straddle injury|Straddle injuries]]
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Increased destruction and fibrosis of the dartos fascia,.
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Dense inflammatory cells, necrotic areas and destruction of the muscular layer.
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Ultrasonography: to check for testicular rupture.
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |_
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Inguinal hernia|Incarcerated Hernia]]<ref name="pmid18244999">{{cite journal |vauthors=Jenkins JT, O'Dwyer PJ |title=Inguinal hernias |journal=BMJ |volume=336 |issue=7638 |pages=269–72 |year=2008 |pmid=18244999 |pmc=2223000 |doi=10.1136/bmj.39450.428275.AD |url=}}</ref><ref name="pmid26987468">{{cite journal |vauthors=Berger D |title=Evidence-Based Hernia Treatment in Adults |journal=Dtsch Arztebl Int |volume=113 |issue=9 |pages=150–7; quiz 158 |year=2016 |pmid=26987468 |pmc=4802357 |doi=10.3238/arztebl.2016.0150 |url=}}</ref>
@@ Line 159: / Line 173: @@
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |Absent
 | style="background: #F5F5F5; padding: 5px; text-align: left;" | +
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |Normal
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |Normal
+* Normal
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
+* Normal
 | style="background: #F5F5F5; padding: 5px; text-align: left;" | -
 | style="background: #F5F5F5; padding: 5px; text-align: left;" | -
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Groin ultrasound or CT scan show presence of bowel and omentum.
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |Valsalva maneuvers performed while palpating the inguinal canal will push a hernia against the examiner's finger.
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Valsalva maneuvers performed while palpating the inguinal canal will push a hernia against the examiner's finger.
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brucellosis]]<ref name="pmid27331193">{{cite journal |vauthors=Kaya F, Kocyigit A, Kaya C, Turkcuer I, Serinken M, Karabulut N |title=Brucellar Testicular Abscess Presenting as a Testicular Mass: Can Color Doppler Sonography be used in Differentiation? |journal=Turk J Emerg Med |volume=15 |issue=1 |pages=43–6 |date=March 2015 |pmid=27331193 |pmc=4909939 |doi=10.5505/1304.7361.2014.82698 |url=}}</ref><ref name="pmid11698991">{{cite journal |vauthors=Navarro-Martínez A, Solera J, Corredoira J, Beato JL, Martínez-Alfaro E, Atiénzar M, Ariza J |title=Epididymoorchitis due to Brucella mellitensis: a retrospective study of 59 patients |journal=Clin. Infect. Dis. |volume=33 |issue=12 |pages=2017–22 |date=December 2001 |pmid=11698991 |doi=10.1086/324489 |url=}}</ref><ref name="pmid17141451">{{cite journal |vauthors=Colmenero JD, Muñoz-Roca NL, Bermudez P, Plata A, Villalobos A, Reguera JM |title=Clinical findings, diagnostic approach, and outcome of Brucella melitensis epididymo-orchitis |journal=Diagn. Microbiol. Infect. Dis. |volume=57 |issue=4 |pages=367–72 |date=April 2007 |pmid=17141451 |doi=10.1016/j.diagmicrobio.2006.09.008 |url=}}</ref><ref name="pmid2313817">{{cite journal |vauthors=Reisman EM, Colquitt LA, Childers J, Preminger GM |title=Brucella orchitis: a rare cause of testicular enlargement |journal=J. Urol. |volume=143 |issue=4 |pages=821–2 |date=April 1990 |pmid=2313817 |doi= |url=}}</ref>
@@ Line 178: / Line 194: @@
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |Painful local lymphadenopathy
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>+</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * CBC-[[Leukocytosis]]
 * raised CRP
 * Immunofluorescent antibody testing
 * Urine analysis and culture - normal
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |Increased blood flow in affected side
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
+* Increased blood flow in affected side
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |
@@ Line 198: / Line 215: @@
 * 2-mercaptoethanol agglutination
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Torsion of the appendix testis
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |Torsion of the appendix testis<ref name="pmid16569689">{{cite journal |vauthors=Rakha E, Puls F, Saidul I, Furness P |title=Torsion of the testicular appendix: importance of associated acute inflammation |journal=J. Clin. Pathol. |volume=59 |issue=8 |pages=831–4 |date=August 2006 |pmid=16569689 |pmc=1860437 |doi=10.1136/jcp.2005.034603 |url=}}</ref><ref name="pmid9651416">{{cite journal |vauthors=Kadish HA, Bolte RG |title=A retrospective review of pediatric patients with epididymitis, testicular torsion, and torsion of testicular appendages |journal=Pediatrics |volume=102 |issue=1 Pt 1 |pages=73–6 |date=July 1998 |pmid=9651416 |doi= |url=}}</ref><ref name="pmid7967303">{{cite journal |vauthors=Okui N, Tomita K, Kimura A, Uekane K, Kawamura T, Teshima S |title=[Heterochronic occurrence of bilateral torsion of appendix testis a case report] |language=Japanese |journal=Nippon Hinyokika Gakkai Zasshi |volume=85 |issue=9 |pages=1395–8 |date=September 1994 |pmid=7967303 |doi= |url=}}</ref><ref name="pmid25704247">{{cite journal |vauthors=Lev M, Ramon J, Mor Y, Jacobson JM, Soudack M |title=Sonographic appearances of torsion of the appendix testis and appendix epididymis in children |journal=J Clin Ultrasound |volume=43 |issue=8 |pages=485–9 |date=October 2015 |pmid=25704247 |doi=10.1002/jcu.22265 |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Unilateral or Bilateral
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Sudden
@@ Line 208: / Line 225: @@
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Normal
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Normal
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Normal blood flow to the testis with an occasional increase on the affected side
@@ Line 218: / Line 236: @@
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * scrotal ultrasound shows the torsed appendage as a lesion of low echogenicity with a central hypoechogenic area.
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |Scrotal wall mayshow the classical "blue dot" sign, which is due to infarction and necrosis of the appendix testis
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
+* Scrotal wall mayshow the classical "blue dot" sign, which is due to infarction and necrosis of the appendix testis
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Henoch-Schönlein purpura|Henoch-Schonlein purpura]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Henoch-Schönlein purpura|Henoch-Schonlein purpura]]<ref name="pmid10934812">{{cite journal |vauthors=Choong CS, Liew KL, Liu PN, Kuo TU, Su CM |title=Acute scrotum in Henoch-Schönlein purpura |journal=Zhonghua Yi Xue Za Zhi (Taipei) |volume=63 |issue=7 |pages=577–80 |date=July 2000 |pmid=10934812 |doi= |url=}}</ref><ref name="pmid27169017">{{cite journal |vauthors=Modi S, Mohan M, Jennings A |title=Acute Scrotal Swelling in Henoch-Schonlein Purpura: Case Report and Review of the Literature |journal=Urol Case Rep |volume=6 |issue= |pages=9–11 |date=May 2016 |pmid=27169017 |pmc=4855902 |doi=10.1016/j.eucr.2016.01.004 |url=}}</ref><ref name="pmid11702171">{{cite journal |vauthors=Dayanir YO, Akdilli A, Karaman CZ, Sönmez F, Karaman G |title=Epididymoorchitis mimicking testicular torsion in Henoch-Schönlein purpura |journal=Eur Radiol |volume=11 |issue=11 |pages=2267–9 |date=2001 |pmid=11702171 |doi=10.1007/s003300100843 |url=}}</ref><ref name="pmid22693978">{{cite journal |vauthors=Akgun C |title=A case of scrotal swelling mimicking testicular torsion preceding Henoch-Schönlein vasculitis |journal=Bratisl Lek Listy |volume=113 |issue=6 |pages=382–3 |date=2012 |pmid=22693978 |doi= |url=}}</ref>
-|  style="background: #F5F5F5; padding: 5px; text-align: center;" |Unilateral
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Unilateral
-|  style="background: #F5F5F5; padding: 5px; text-align: center;" |Sudden
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Sudden
-|  style="background: #F5F5F5; padding: 5px; text-align: center;" | -
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-|  style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
-|  style="background: #F5F5F5; padding: 5px; text-align: center;" |+
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-|  style="background: #F5F5F5; padding: 5px; text-align: center;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-|  style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-|  style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-|  style="background: #F5F5F5; padding: 5px; text-align: center;" | -
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-|  style="background: #F5F5F5; padding: 5px; text-align: center;" |
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Serum IgA levels are elevated
 * Elevated ESR
-|  style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-|  style="background: #F5F5F5; padding: 5px; text-align: left;" |
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Sore throat 2-3 weeks back
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * Light microscopy shows  leukocytoclastic vasculitis in postcapillary venules with IgA deposition
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Biopsy
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Palpable purpura
 * Age at onset is less than 20 years
 * Acute abdominal pain
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fourniers gangrene|Fournier's gangrene]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fourniers gangrene|Fournier's gangrene]]<ref name="pmid29146218">{{cite journal |vauthors=Voelzke BB, Hagedorn JC |title=Presentation and Diagnosis of Fournier Gangrene |journal=Urology |volume=114 |issue= |pages=8–13 |date=April 2018 |pmid=29146218 |doi=10.1016/j.urology.2017.10.031 |url=}}</ref><ref name="pmid28328332">{{cite journal |vauthors=Huang CS |title=Fournier's Gangrene |journal=N. Engl. J. Med. |volume=376 |issue=12 |pages=1158 |date=March 2017 |pmid=28328332 |doi=10.1056/NEJMicm1609306 |url=}}</ref><ref name="pmid29052826">{{cite journal |vauthors=Yücel M, Özpek A, Başak F, Kılıç A, Ünal E, Yüksekdağ S, Acar A, Baş G |title=Fournier's gangrene: A retrospective analysis of 25 patients |journal=Ulus Travma Acil Cerrahi Derg |volume=23 |issue=5 |pages=400–404 |date=September 2017 |pmid=29052826 |doi=10.5505/tjtes.2017.01678 |url=}}</ref><ref name="pmid26138056">{{cite journal |vauthors=Namkoong H, Ishii M, Koizumi M, Betsuyaku T |title=Fournier's gangrene: a surgical emergency |journal=Infection |volume=44 |issue=1 |pages=143–4 |date=February 2016 |pmid=26138056 |doi=10.1007/s15010-015-0816-4 |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Bilateral
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Sudden
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>+</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>+</nowiki>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>+</nowiki>
@@ Line 262: / Line 281: @@
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Computed tomography (CT) scan shows most useful finding is presence of gas in soft tissues.
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Computed tomography (CT) scan shows most useful finding is presence of gas in soft tissues.
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Patient show signs of  tense edema outside the involved skin, blisters, bullae, crepitus, and subcutaneous gas.
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-!Scrotal Swelling
 !Diseases
 !Unilateral /Bilateral swelling
@@ Line 272: / Line 291: @@
 ! colspan="1" rowspan="1" |Fever
 !Urinary symptoms
-!Tenderness
+!Tender<be>-ness
 !Erythema
 ! colspan="1" rowspan="1" |Discharge
@@ Line 284: / Line 303: @@
 !Additional findings
 |-
-| rowspan="11" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Painless
+! colspan="16" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |Painless
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fragile X syndrome|Fragile X]]   [[Macroorchidism]]
+|-
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fragile X syndrome|Fragile X]]   [[Macroorchidism]]<ref name="pmid6348096">{{cite journal |vauthors=Hagerman RJ, McBogg P, Hagerman PJ |title=The fragile X syndrome: history, diagnosis, and treatment |journal=J Dev Behav Pediatr |volume=4 |issue=2 |pages=122–30 |date=June 1983 |pmid=6348096 |doi= |url=}}</ref><ref name="pmid9678703">{{cite journal |vauthors=de Vries BB, Halley DJ, Oostra BA, Niermeijer MF |title=The fragile X syndrome |journal=J. Med. Genet. |volume=35 |issue=7 |pages=579–89 |date=July 1998 |pmid=9678703 |pmc=1051369 |doi= |url=}}</ref><ref name="pmid8190590">{{cite journal |vauthors=Lachiewicz AM, Dawson DV |title=Do young boys with fragile X syndrome have macroorchidism? |journal=Pediatrics |volume=93 |issue=6 Pt 1 |pages=992–5 |date=June 1994 |pmid=8190590 |doi= |url=}}</ref><ref name="pmid25767309">{{cite journal |vauthors=Saldarriaga W, Tassone F, González-Teshima LY, Forero-Forero JV, Ayala-Zapata S, Hagerman R |title=Fragile X syndrome |journal=Colomb. Med. |volume=45 |issue=4 |pages=190–8 |date=2014 |pmid=25767309 |pmc=4350386 |doi= |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px;" |Bilateral
 | style="background: #F5F5F5; padding: 5px;" |Gradual
@@ Line 295: / Line 315: @@
 | style="background: #F5F5F5; padding: 5px;" |Absent
 | style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |Normal
+| style="background: #F5F5F5; padding: 5px;" |
+* Normal
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" |Increased volume of testis
-| style="background: #F5F5F5; padding: 5px;" |FMR1 DNA analysis
+| style="background: #F5F5F5; padding: 5px;" |
+* FMR1 DNA analysis
 | style="background: #F5F5F5; padding: 5px;" |
 * Long and narrow face with prominent forehead and chin (prognathism)
@@ Line 305: / Line 327: @@
 * Intellectual Disability
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Testicular Tumors
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |Testicular Tumors<ref name="pmid28967388">{{cite journal |vauthors=Shen J, Bi Y, Wang X, Lu L, Tang L, Liu Y, Chen H, Zhang B |title=Epidemiologic study of 230 cases of testicular/paratesticular tumors or masses: 15-year experience of a single center |journal=J. Pediatr. Surg. |volume=52 |issue=12 |pages=2056–2060 |date=December 2017 |pmid=28967388 |doi=10.1016/j.jpedsurg.2017.08.027 |url=}}</ref><ref name="pmid25096628">{{cite journal |vauthors=Hohšteter M, Artuković B, Severin K, Kurilj AG, Beck A, Šoštarić-Zuckermann IC, Grabarević Ž |title=Canine testicular tumors: two types of seminomas can be differentiated by immunohistochemistry |journal=BMC Vet. Res. |volume=10 |issue= |pages=169 |date=August 2014 |pmid=25096628 |pmc=4129470 |doi=10.1186/s12917-014-0169-8 |url=}}</ref><ref name="pmid22677786">{{cite journal |vauthors=McDonald MW, Reed AB, Tran PT, Evans LA |title=Testicular tumor ultrasound characteristics and association with histopathology |journal=Urol. Int. |volume=89 |issue=2 |pages=196–202 |date=2012 |pmid=22677786 |doi=10.1159/000338771 |url=}}</ref><ref name="pmid28549629">{{cite journal |vauthors=Naouar S, Braiek S, El Kamel R |title=Testicular tumors of adrenogenital syndrome: From physiopathology to therapy |journal=Presse Med |volume=46 |issue=6 Pt 1 |pages=572–578 |date=June 2017 |pmid=28549629 |doi=10.1016/j.lpm.2017.05.006 |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px;" |Unilateral or bilateral
 | style="background: #F5F5F5; padding: 5px;" |Gradual
 | style="background: #F5F5F5; padding: 5px;" |±
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |Absent
 | style="background: #F5F5F5; padding: 5px;  text-align: center;" | ±
 | style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px;" |Present
-| style="background: #F5F5F5; padding: 5px;" |+
+| style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
 * Increased serum beta-hCG or alpha fetoprotien (AFP)
-| style="background: #F5F5F5; padding: 5px;" |-
+| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |-
+| style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" |Seminoma  shows findings such as:
 * Large [[cells]] with watery [[cytoplasm]]
 * Fried egg [[appearance]]
-| style="background: #F5F5F5; padding: 5px;" |Biopsy
+| style="background: #F5F5F5; padding: 5px;" |
+* Biopsy
 | style="background: #F5F5F5; padding: 5px;" |
 * Pain in the back or abdomen
@@ Line 331: / Line 354: @@
 * [[Infertility]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hydrocele]]<ref name="pmid174600034">{{cite journal |vauthors=Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H |title=Sonographic findings of groin masses |journal=J Ultrasound Med |volume=26 |issue=5 |pages=605–14 |year=2007 |pmid=17460003 |doi= |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hydrocele]]<ref name="pmid28551604">{{cite journal |vauthors=Costantino E, Ganesan GS, Plaire JC |title=Abdominoscrotal hydrocele in an infant boy |journal=BMJ Case Rep |volume=2017 |issue= |pages= |date=May 2017 |pmid=28551604 |doi=10.1136/bcr-2017-220370 |url=}}</ref><ref name="pmid26708803">{{cite journal |vauthors=Kaefer M, Agarwal D, Misseri R, Whittam B, Hubert K, Szymanski K, Rink R, Cain MP |title=Treatment of contralateral hydrocele in neonatal testicular torsion: Is less more? |journal=J Pediatr Urol |volume=12 |issue=5 |pages=306.e1–306.e4 |date=October 2016 |pmid=26708803 |doi=10.1016/j.jpurol.2015.07.009 |url=}}</ref><ref name="pmid174600034">{{cite journal |vauthors=Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H |title=Sonographic findings of groin masses |journal=J Ultrasound Med |volume=26 |issue=5 |pages=605–14 |year=2007 |pmid=17460003 |doi= |url=}}</ref><ref name="pmid28389795">{{cite journal |vauthors=Chen Y, Wang F, Zhong H, Zhao J, Li Y, Shi Z |title=A systematic review and meta-analysis concerning single-site laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia and hydrocele |journal=Surg Endosc |volume=31 |issue=12 |pages=4888–4901 |date=December 2017 |pmid=28389795 |doi=10.1007/s00464-017-5491-3 |url=}}</ref><ref name="pmid21592287">{{cite journal |vauthors=Rioja J, Sánchez-Margallo FM, Usón J, Rioja LA |title=Adult hydrocele and spermatocele |journal=BJU Int. |volume=107 |issue=11 |pages=1852–64 |date=June 2011 |pmid=21592287 |doi=10.1111/j.1464-410X.2011.10353.x |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Bilateral
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |Gradual
@@ Line 341: / Line 364: @@
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |Absent
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Normal
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+* Normal
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |[[Ultrasound|Ultrasound:]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-simple fluid collection
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |Transillumination test is positive
+* [[Ultrasound|Ultrasound:]] simple fluid collection
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
+* Transillumination test is positive
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Varicocele]]<ref name="pmid174600033">{{cite journal |vauthors=Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H |title=Sonographic findings of groin masses |journal=J Ultrasound Med |volume=26 |issue=5 |pages=605–14 |year=2007 |pmid=17460003 |doi= |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Varicocele]]<ref name="pmid28865534">{{cite journal |vauthors=Clavijo RI, Carrasquillo R, Ramasamy R |title=Varicoceles: prevalence and pathogenesis in adult men |journal=Fertil. Steril. |volume=108 |issue=3 |pages=364–369 |date=September 2017 |pmid=28865534 |doi=10.1016/j.fertnstert.2017.06.036 |url=}}</ref><ref name="pmid174600033">{{cite journal |vauthors=Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H |title=Sonographic findings of groin masses |journal=J Ultrasound Med |volume=26 |issue=5 |pages=605–14 |year=2007 |pmid=17460003 |doi= |url=}}</ref><ref name="pmid28851509">{{cite journal |vauthors=Locke JA, Noparast M, Afshar K |title=Treatment of varicocele in children and adolescents: A systematic review and meta-analysis of randomized controlled trials |journal=J Pediatr Urol |volume=13 |issue=5 |pages=437–445 |date=October 2017 |pmid=28851509 |doi=10.1016/j.jpurol.2017.07.008 |url=}}</ref><ref name="pmid26806081">{{cite journal |vauthors=Shridharani A, Owen RC, Elkelany OO, Kim ED |title=The significance of clinical practice guidelines on adult varicocele detection and management |journal=Asian J. Androl. |volume=18 |issue=2 |pages=269–75 |date=2016 |pmid=26806081 |doi=10.4103/1008-682X.172641 |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |Unilateral
 (Mainly left)
@@ Line 360: / Line 385: @@
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |Absent
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Elevations in unstimulated luteinizing hormone and follicle stimulating hormone levels  may be seen in when associated with infertility in adults
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Thrombosis of Inferiror vena cava
-●Thrombosis of Right renal vein
+* Thrombosis of Right renal vein
+* Abdominal mass
-●Abdominal mass
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * [[Renal cancer]]
 * [[Nephrectomy]]
 * Nut-cracker syndrome
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: left;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |[[Ultrasonography:]]
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
-[[tortuous]], [[tubular]], anechoic structures adjacent to the testis corresponding to dilated veins of the [[pampiniform plexus]] with calibers of 2–3 mm during the [[Valsalva maneuver]]
+* Ultrasonography: [[tortuous]], [[tubular]], anechoic structures adjacent to the testis corresponding to dilated veins of the [[pampiniform plexus]] with calibers of 2–3 mm during the [[Valsalva maneuver]]
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Infertility
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Spermatocele]]<ref name="pmid174600032">{{cite journal |vauthors=Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H |title=Sonographic findings of groin masses |journal=J Ultrasound Med |volume=26 |issue=5 |pages=605–14 |year=2007 |pmid=17460003 |doi= |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Spermatocele]]<ref name="pmid174600032">{{cite journal |vauthors=Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H |title=Sonographic findings of groin masses |journal=J Ultrasound Med |volume=26 |issue=5 |pages=605–14 |year=2007 |pmid=17460003 |doi= |url=}}</ref><ref name="pmid21592287">{{cite journal |vauthors=Rioja J, Sánchez-Margallo FM, Usón J, Rioja LA |title=Adult hydrocele and spermatocele |journal=BJU Int. |volume=107 |issue=11 |pages=1852–64 |date=June 2011 |pmid=21592287 |doi=10.1111/j.1464-410X.2011.10353.x |url=}}</ref><ref name="pmid17606432">{{cite journal |vauthors=Yeh HC, Wang CJ, Liu CC, Wu WJ, Chou YH, Huang CH |title=Giant spermatocele mimicking hydrocele: a case report |journal=Kaohsiung J. Med. Sci. |volume=23 |issue=7 |pages=366–9 |date=July 2007 |pmid=17606432 |doi=10.1016/S1607-551X(09)70423-1 |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |Unilateral
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |Gradual
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: left;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |Absent
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |<nowiki>-</nowiki>
@@ Line 388: / Line 411: @@
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |Absent
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: left;" | -
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Falling snow, resulting from internal echoes moving away from the transducer
@@ Line 396: / Line 419: @@
 | style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Epididymal scarring is seen
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |[[Ultrasonography]]:
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
-hypoechoic with posterior acoustic enhancement
+* [[Ultrasonography]]: hypoechoic with posterior acoustic enhancement
-| style="background: #F5F5F5; padding: 5px; text-align: left;" |Transillumination test is positive
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
+* Transillumination test is positive
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Inguinal hernia|Inguino-scrotal hernia]]<ref name="pmid269874682">{{cite journal |vauthors=Berger D |title=Evidence-Based Hernia Treatment in Adults |journal=Dtsch Arztebl Int |volume=113 |issue=9 |pages=150–7; quiz 158 |year=2016 |pmid=26987468 |pmc=4802357 |doi=10.3238/arztebl.2016.0150 |url=}}</ref><ref name="pmid18244999" />
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |Scrotal edema<ref name="pmid28316300">{{cite journal |vauthors=Geffre M, Maki C, Maier S |title=Acute Scrotal Edema in Cirrhotic after Laparoscopic Cholecystectomy |journal=Am Surg |volume=83 |issue=3 |pages=e93–95 |date=March 2017 |pmid=28316300 |doi= |url=}}</ref><ref name="pmid28625172">{{cite journal |vauthors=Esposito F, Sanchez O, Siebert JN, Manzano S |title=Acute scrotal idiopathic edema: A misleading erythema |journal=CJEM |volume=20 |issue=S2 |pages=S37 |date=October 2018 |pmid=28625172 |doi=10.1017/cem.2017.343 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-|-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Scrotal edema
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Bilateral and can extend to perineum
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Gradual
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |+
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * [[Eosinophilia]]
@@ Line 438: / Line 445: @@
 * Hepatic Cirrhosis
 * Insect Bite
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Kidney or Liver biopsy
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Occurs between 4-12 years of age.
+* Kidney or Liver biopsy
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Occurs between 4-12 years of age.
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sebaceous cyst]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sebaceous cyst]]<ref name="pmid26400592">{{cite journal |vauthors=Solanki A, Narang S, Kathpalia R, Goel A |title=Scrotal calcinosis: pathogenetic link with epidermal cyst |journal=BMJ Case Rep |volume=2015 |issue= |pages= |date=September 2015 |pmid=26400592 |pmc=4593290 |doi=10.1136/bcr-2015-211163 |url=}}</ref><ref name="pmid25297369">{{cite journal |vauthors=Prasad KK, Manjunath RD |title=Multiple epidermal cysts of scrotum |journal=Indian J. Med. Res. |volume=140 |issue=2 |pages=318 |date=August 2014 |pmid=25297369 |pmc=4216510 |doi= |url=}}</ref><ref name="pmid25015622">{{cite journal |vauthors=Ząbkowski T, Wajszczuk M |title=Epidermoid cyst of the scrotum: a clinical case |journal=Urol J |volume=11 |issue=3 |pages=1706–9 |date=July 2014 |pmid=25015622 |doi= |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Unilateral
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Gradual
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |+
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Normal
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Normal
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * [[Fibrous tissues]] and fluids
 * A fatty,([[keratinous]]), substance that resembles cottage cheese,.
 * A viscous, serosanguinous fluid (containing [[purulent]] and bloody material).
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Histological examination
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Histological examination
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * Freely movable on palpation.
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Scrotum Carcinoma|Carcinoma of the scrotum]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Scrotum Carcinoma|Carcinoma of the scrotum]]<ref name="pmid21791720">{{cite journal |vauthors=Casasola Chamorro J, Gutiérrez García S, de Blas Gómez V |title=Scrotal carcinoma |journal=Arch. Esp. Urol. |volume=64 |issue=6 |pages=541–3 |date=July 2011 |pmid=21791720 |doi= |url=}}</ref><ref name="pmid26113906">{{cite journal |vauthors=Halfya A, Elmortaji K, Redouane R, Fethi M, Rafik A, Mohamed E, Abdessamad C |title=[Squamous cell carcinomas of the scrotum: about 7 cases with review of the literature] |language=French |journal=Pan Afr Med J |volume=20 |issue= |pages=163 |date=2015 |pmid=26113906 |pmc=4469445 |doi=10.11604/pamj.2015.20.163.5991 |url=}}</ref><ref name="pmid26959967">{{cite journal |vauthors=Armas-Alvarez AL, Salinas-Sánchez AS, Atienzar-Tobarra M, Virseda-Rodríguez JA |title=Scrotal tumors |journal=Arch. Esp. Urol. |volume=69 |issue=2 |pages=86–9 |date=March 2016 |pmid=26959967 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Gradual
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |+
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Normal
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |Absent
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Normal
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * keratinocytic dysplasia involving the full thickness of the epidermis without infiltration of atypical cells into the dermis.
 * The keratinocytes are pleomorphic with hyperchromatic nuclei
 * Numerous mitoses are present.
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Biopsy
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Biopsy
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * Scaly patch or plaque is seen over the testis.
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[filariasis|Chylocele]] ([[Filariasis]])
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[filariasis|Chylocele]] ([[Filariasis]])<ref name="pmid25989164">{{cite journal |vauthors=Otabil KB, Tenkorang SB |title=Filarial hydrocele: a neglected condition of a neglected tropical disease |journal=J Infect Dev Ctries |volume=9 |issue=5 |pages=456–62 |date=March 2015 |pmid=25989164 |doi=10.3855/jidc.5346 |url=}}</ref><ref name="pmid28507911">{{cite journal |vauthors=Janssen KM, Willis CJ, Anderson M, Gelnett MS, Wickersham EL, Brand TC |title=Filariasis Orchitis-Differential for Acute Scrotum Pathology |journal=Urol Case Rep |volume=13 |issue= |pages=117–119 |date=July 2017 |pmid=28507911 |pmc=5426035 |doi=10.1016/j.eucr.2017.04.002 |url=}}</ref><ref name="pmid21771446">{{cite journal |vauthors=Yagain K, Mathew M |title=Filariasis presenting as a scrotal nodule in a 2 year old child: a case report |journal=Asian Pac J Trop Med |volume=4 |issue=2 |pages=167–8 |date=February 2011 |pmid=21771446 |doi=10.1016/S1995-7645(11)60062-X |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Unilateral or Bilateral
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Gradually/Rapidly
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Gradually
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |+
+Rapidly
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |+
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |Absent
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Circulating filarial antigen (CFA) assays are positve
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Lymphatics containing worms can be differentiated from the blood vessels by irregular movement
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |CFA assay
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* CFA assay
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Ultrasound demonstrates living worms which has been described as  "filarial dance" sign.
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Scrotoliths
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |Scrotoliths<ref name="pmid21935341">{{cite journal |vauthors=Khallouk A, Yazami OE, Mellas S, Tazi MF, El Fassi J, Farih MH |title=Idiopathic scrotal calcinosis: a non-elucidated pathogenesis and its surgical treatment |journal=Rev Urol |volume=13 |issue=2 |pages=95–7 |date=2011 |pmid=21935341 |pmc=3176555 |doi= |url=}}</ref><ref name="pmid16836500">{{cite journal |vauthors=Noël B, Bron C, Künzle N, De Heller M, Panizzon RG |title=Multiple nodules of the scrotum: histopathological findings and surgical procedure. A study of five cases |journal=J Eur Acad Dermatol Venereol |volume=20 |issue=6 |pages=707–10 |date=July 2006 |pmid=16836500 |doi=10.1111/j.1468-3083.2006.01578.x |url=}}</ref><ref name="pmid8790314">{{cite journal |vauthors=Polk P, McCutchen WT, Phillips JG, Biggs PJ |title=Polypoid scrotal calcinosis: an uncommon variant of scrotal calcinosis |journal=South. Med. J. |volume=89 |issue=9 |pages=896–7 |date=September 1996 |pmid=8790314 |doi= |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Unilateral
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Gradual
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |+
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Normal
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |Absent
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Normal
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Trauma
 * Torsion of appendix
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |-
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |Ultrasound
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |
+* Ultrasound
+| style="background: #F5F5F5; padding: 5px; text-align: left;" |
 * Ultrasound shows  mobile hyperechoic extratesticular focus in the potential tunica space.
 |}

Scrotal mass differential diagnosis: Difference between revisions

Latest revision as of 15:16, 23 October 2019

Overview

Differentiating Scrotal masses from the other Diseases

References

Navigation menu