Scrotal mass: Difference between revisions

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'''For patient information, click [[Xyz (patient information)|here]]'''
'''For patient information, click [[Xyz (patient information)|here]]'''


{{CMG}}{{AE}} {{NE}}{{SR}}
{{CMG}}{{AE}}{{NE}}{{SR}}


{{SK}} Scrotal lump
{{SK}} Scrotal lump
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==[[Scrotal mass historical perspective|Historical Perspective]]==
==[[Scrotal mass historical perspective|Historical Perspective]]==
==[[Scrotal mass classification|Classification]]==
==[[Scrotal mass classification|Classification]]==


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==[[Scrotal mass causes|Causes]]==
==[[Scrotal mass causes|Causes]]==
*Scrotal mass may be caused by [[tumor]], [[infection]], [[injury]], [[inflammation]], or fluid buildup, which can cause different types of masses.<ref name="causeofscrotalmasses">Causes of scrotal masses. The Urology Group 2016. http://urologygroup.com/conditions-we-treat/scrotal-masses/. Accessed on March 17, 2016</ref>
{|style="width:85%; height:90px" border="1"
!style="padding: 0 5px; background: #DCDCDC" colspan=5 | {{fontcolor|#000|'''Common Causes of Scrotal Mass'''<br><sub>Adapted from American Academy of Family Physicians.<ref name=causescrotalmass1>Scrotal mass. American Academy of Family Physicians 2016. http://www.aafp.org/afp/2008/1115/p1165.html. Accessed on March 18, 2016</ref></sub>}}
|-
! Cause
! Clinical Presentation
! Diagnosis
! Treatment
|-
| style="padding: 0 5px; background: #F5F5F5" align=center| [[Testicular torsion]]
| style="padding: 0 5px; background: #F5F5F5" | Acute unilateral pain and swelling<br>High position of the testicle<br>Abnormal cremasteric reflex<br>Nausea/vomiting
| style="padding: 0 5px; background: #F5F5F5" | Mostly clinical, with or without sonography
| style="padding: 0 5px; background: #F5F5F5" | Surgery
|-
| style="padding: 0 5px; background: #F5F5F5" align=center | [[Appendix testis|Torsion of the testicular appendage]]
| style="padding: 0 5px; background: #F5F5F5" | Acute unilateral pain<br>No swelling<br>Blue dot sign(bluish discoloration of the scrotum over the superior pole)
| style="padding: 0 5px; background: #F5F5F5" | Sonography
| style="padding: 0 5px; background: #F5F5F5" | Pain control
|-
| style="padding: 0 5px; background: #F5F5F5" align=center | [[epididymo-orchitis|Epididymis/orchitis]]
| style="padding: 0 5px; background: #F5F5F5" | Acute unilateral pain and swelling<br>Normal position of the testicle<br>Erythema of the scrotal skin<br>Fever<br>Dysuria
| style="padding: 0 5px; background: #F5F5F5" | Mostly clinical, with or without sonography
| style="padding: 0 5px; background: #F5F5F5" | Ceftriaxone and doxyxycline
|-
| style="padding: 0 5px; background: #F5F5F5" align=center | [[Hematocele]]
| style="padding: 0 5px; background: #F5F5F5" | History of trauma<br>Pain and swelling
| style="padding: 0 5px; background: #F5F5F5" | Sonography or surgerical exploraion
| style="padding: 0 5px; background: #F5F5F5" | Main focus on pain control. Surgery, if needed
|-
| style="padding: 0 5px; background: #F5F5F5" align=center | [[Inguinal hernia]]
| Unilateral bulge in the scrotum<br>Pain with Valsalva maneuvers
| style="padding: 0 5px; background: #F5F5F5" | Physical examination, sonography
| style="padding: 0 5px; background: #F5F5F5" | Surgery
|-
| style="padding: 0 5px; background: #F5F5F5" align=center | [[Hydrocele]]
| style="padding: 0 5px; background: #F5F5F5" | Swelling
| style="padding: 0 5px; background: #F5F5F5" | Transillumination, sonography
| style="padding: 0 5px; background: #F5F5F5" | Main focus on pain control. Surgery, if needed
|-
| style="padding: 0 5px; background: #F5F5F5" align=center | [[Varicocele]]
| style="padding: 0 5px; background: #F5F5F5" | Dull testicular ache while in standing position<br>
Scrotal mass
| style="padding: 0 5px; background: #F5F5F5" | "Bag of worms" on palpation
| style="padding: 0 5px; background: #F5F5F5" | Scrotal support, surgery if needed
|-
| style="padding: 0 5px; background: #F5F5F5" align=center | [[Testicular cancer]]
| style="padding: 0 5px; background: #F5F5F5" | Unilateral, firm nodule
| style="padding: 0 5px; background: #F5F5F5" | Sonography, positive tumor markers
| style="padding: 0 5px; background: #F5F5F5" | Surgery
|-
| style="padding: 0 5px; background: #F5F5F5" align=center | [[Skin cancer]]
| style="padding: 0 5px; background: #F5F5F5" | History of carcinogens<br>Erosive, vascular, hyperkeratotic, or nonhealing; irregular border; color changes
| style="padding: 0 5px; background: #F5F5F5" | Biopsy
| style="padding: 0 5px; background: #F5F5F5" | Surgery
|}
===Causes by Anatomic Origin===
{|style="width:85%; height:90px" border="1"
!style="padding: 0 5px; background: #DCDCDC" colspan=5 | {{fontcolor|#000|'''Scrotal Mass'''<br><sub>Adapted from American Academy of Family Physicians.<ref name=causescrotalmass1>Scrotal mass. American Academy of Family Physicians 2016. http://www.aafp.org/afp/2008/1115/p1165.html. Accessed on March 18, 2016</ref></sub>}}
|-
! style="padding: 0 5px; background: #4479BA" | {{fontcolor|#FFF|Anatomical Origin}}
! style="padding: 0 5px; background: #4479BA" | {{fontcolor|#FFF|Lesion/Condition}}
! style="padding: 0 5px; background: #4479BA" | {{fontcolor|#FFF|Onset/Progression}}
! style="padding: 0 5px; background: #4479BA" | {{fontcolor|#FFF|Pain/Tenderness}}
! style="padding: 0 5px; background: #4479BA" | {{fontcolor|#FFF|Aggravating/Alleviating Factors, Associated Symptoms}}
|-
| rowspan="2" style="padding: 0 5px; background: #F5F5F5" |[[Skin]]
| style="padding: 0 5px; background: #F5F5F5" | '''[[Sebaceous cyst]]'''
| style="padding: 0 5px; background: #F5F5F5" | Acute/chronic, stable
| style="padding: 0 5px; background: #F5F5F5" | No
| style="padding: 0 5px; background: #F5F5F5" | ---
|-
| style="padding: 0 5px; background: #F5F5F5" | '''[[Squamous cell carcinoma]]'''
| style="padding: 0 5px; background: #F5F5F5" | Chronic, progressive
| style="padding: 0 5px; background: #F5F5F5" | No
| style="padding: 0 5px; background: #F5F5F5" | ---
|-
| rowspan="2" style="padding: 0 5px; background: #F5F5F5" | [[Tunica vaginalis testis]]
| style="padding: 0 5px; background: #F5F5F5" | '''[[Hydrocele]]'''
| style="padding: 0 5px; background: #F5F5F5" | Acute/chronic, stable
| style="padding: 0 5px; background: #F5F5F5" | No
| style="padding: 0 5px; background: #F5F5F5" | Positive '''transillumination'''
|-
| style="padding: 0 5px; background: #F5F5F5" | '''[[Hematocele]]'''
| style="padding: 0 5px; background: #F5F5F5" | Acute, caused by trauma
| style="padding: 0 5px; background: #F5F5F5" | Yes
| style="padding: 0 5px; background: #F5F5F5" | Negative transillumination
|-
| rowspan="2" style="padding: 0 5px; background: #F5F5F5" | [[appendix testis|Processus vaginalis testis]]
| style="padding: 0 5px; background: #F5F5F5" | '''[[Indirect inguinal hernia]]'''
| style="padding: 0 5px; background: #F5F5F5" | Acute/chronic, stable or progressive
| style="padding: 0 5px; background: #F5F5F5" | No; yes, if strangulated
| style="padding: 0 5px; background: #F5F5F5" | May enlarge with Valsalva-type maneuvers; size may fluctuate
|-
| style="padding: 0 5px; background: #F5F5F5" | '''[[Hydrocele]]'''
| style="padding: 0 5px; background: #F5F5F5" | Chronic, stable
| style="padding: 0 5px; background: #F5F5F5" | No
| style="padding: 0 5px; background: #F5F5F5" | ---
|-
| style="padding: 0 5px; background: #F5F5F5" | [[Pampiniform plexus]]
| style="padding: 0 5px; background: #F5F5F5" | '''[[Varicocele]]'''
| style="padding: 0 5px; background: #F5F5F5" | Chronic, stable
| style="padding: 0 5px; background: #F5F5F5" | No
| style="padding: 0 5px; background: #F5F5F5" | Characteristic "'''bag of worms'''" consistency
|-
| rowspan="2" style="padding: 0 5px; background: #F5F5F5" | [[Epididymis]]
| style="padding: 0 5px; background: #F5F5F5" | '''[[Epididymitis]]'''
| style="padding: 0 5px; background: #F5F5F5" | Acute, progressive
| style="padding: 0 5px; background: #F5F5F5" | Yes
| style="padding: 0 5px; background: #F5F5F5" | May have symptoms of urinary tract infection (fever, chills, dysuria, frequency, and urgency)
|-
| style="padding: 0 5px; background: #F5F5F5" | '''[[Spermatocele]]'''
| style="padding: 0 5px; background: #F5F5F5" | Chronic, stable
| style="padding: 0 5px; background: #F5F5F5" | No
| style="padding: 0 5px; background: #F5F5F5" | ---
|-
| rowspan="4" style="padding: 0 5px; background: #F5F5F5" | [[Testis]]
| style="padding: 0 5px; background: #F5F5F5" | '''[[Testicular torsion]]'''
| style="padding: 0 5px; background: #F5F5F5" | Acute, progressive
| style="padding: 0 5px; background: #F5F5F5" | Yes
| style="padding: 0 5px; background: #F5F5F5" | Elevation of testis may '''aggravate''' pain; abnormal testicular lie; cremasteric reflex usually '''absent'''
|-
| style="padding: 0 5px; background: #F5F5F5" | '''[[appendix testis|Appendix testis torsion]]'''
| style="padding: 0 5px; background: #F5F5F5" | Acute, stable
| style="padding: 0 5px; background: #F5F5F5" | Yes
| style="padding: 0 5px; background: #F5F5F5" | Blue dot sign
|-
| style="padding: 0 5px; background: #F5F5F5" | '''[[Orchitis]]'''
| style="padding: 0 5px; background: #F5F5F5" | Acute, self-limited
| style="padding: 0 5px; background: #F5F5F5" | Yes
| style="padding: 0 5px; background: #F5F5F5" | Elevation of testis may '''relieve''' pain, may have systemic symptoms of viral illness
|-
| style="padding: 0 5px; background: #F5F5F5" | '''[[Testicular cancer]]'''
| style="padding: 0 5px; background: #F5F5F5" | Chronic, progressive
| style="padding: 0 5px; background: #F5F5F5" | No
| style="padding: 0 5px; background: #F5F5F5" | ---
|}
===Causes by Organ System===
{|style="width:85%; height:90px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[Sebaceous cyst]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Thrombosis spermatic vein]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Mumps]], [[Filariasis]], [[Leprosy]], [[Orchitis]], [[Gumma|Syphilitic gumma]], [[Tuberculosis]], [[Amebiasis]], [[Epididymitis]], [[Granulomatous epididymitis]], [[Seminal vesiculitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| '''Benign:''' [[Germ cell tumor]], [[Teratoma]], [[Thecoma]], [[Sertoli-Leydig cell tumor]], [[Fibroma]], [[Chimney sweeps' carcinoma]], [[Epididymis cyst]], [[Seminal vesicle cyst]], [[Urethral gland cyst]]
'''Malignant:''' [[Germ cell tumor]], [[Seminoma]], [[Embryonal carcinoma]], [[Yolk sac tumor]], [[Choriocarcinoma]], [[Teratoma]], [[Granulosa cell tumor]], [[Sertoli-Leydig cell tumor]], [[Adenocarcinoma]], [[Mesothelioma]], [[Rhabdomyosarcoma]], [[Chimney sweeps' carcinoma]], [[Diffuse large B-cell lymphoma]]
'''Metastatic tumors:''' [[Diffuse large B-cell lymphoma]]
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Testicular injury]], [[Testicular hematoma]], [[Spermatic cord injury]], [[Fracture of testis]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| [[Hematocele]]，[[Hydrocele]]，[[Spermatocele]], [[Varicocele]], [[Testicular torsion]], [[Epididymis torsion]], [[Spermatic cord torsion]], [[Inguinal hernia]], [[Richter hernia]], [[Femoral hernia]], [[Incarcerated hernia]], [[Irreducible hernia]], [[Strangulated hernia]], [[Testicular abscess]], [[Scrotum abscess]], [[Idiopathic scrotal edema]], [[Seminal vesicle calculus]]
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}
==References==
{{Reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Urology]]


==[[Scrotal mass differential diagnosis|Differential Diagnosis]]==
==[[Scrotal mass differential diagnosis|Differential Diagnosis]]==
Line 288: Line 23:


==[[Scrotal mass screening|Screening]]==
==[[Scrotal mass screening|Screening]]==
==[[Scrotal mass natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==
==Diagnosis==
[[Scrotal mass diagnostic study of choice|Diagnostic study of choice]] | [[Scrotal mass evaluation|Evaluation of Scrotal Mass]] | [[Scrotal mass history and symptoms|History and Symptoms]] | [[Scrotal mass physical examination|Physical Examination]] | [[Scrotal mass laboratory Findings|Laboratory Findings]] | [[Scrotal mass electrocardiogram|Electrocardiogram]] | [[Scrotal mass x ray|X-Ray Findings]] | [[Scrotal mass CT scan|CT-Scan Findings]] | [[Scrotal mass MRI|MRI Findings]] | [[Scrotal mass biopsy|Biopsy]] | [[Scrotal mass other imaging findings|Other Imaging Findings]] | [[Scrotal mass other diagnostic studies|Other Diagnostic Studies]]
[[Scrotal mass diagnostic study of choice|Diagnostic study of choice]] | [[Scrotal mass evaluation|Evaluation of Scrotal Mass]] | [[Scrotal mass history and symptoms|History and Symptoms]] | [[Scrotal mass physical examination|Physical Examination]] | [[Scrotal mass laboratory Findings|Laboratory Findings]] | [[Scrotal mass electrocardiogram|Electrocardiogram]] | [[Scrotal mass x ray|X-Ray Findings]] | [[Scrotal mass CT scan|CT-Scan Findings]] | [[Scrotal mass MRI|MRI Findings]] | [[Scrotal mass biopsy|Biopsy]] | [[Scrotal mass other imaging findings|Other Imaging Findings]] | [[Scrotal mass other diagnostic studies|Other Diagnostic Studies]]
==Treatment==
[[Scrotal mass Medical Therapy|Medical Therapy]] | [[Scrotal mass Surgery|Surgery]]|[[Xyz primary prevention|Primary Prevention]] | [[Xyz secondary prevention|Secondary Prevention]] | [[Xyz cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Xyz future or investigational therapies|Future or Investigational Therapies]]


==Case Studies==
==Case Studies==

Latest revision as of 16:56, 17 December 2019

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

Synonyms and keywords: Scrotal lump

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differential Diagnosis

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice | Evaluation of Scrotal Mass | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-Ray Findings | CT-Scan Findings | MRI Findings | Biopsy | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery|Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1

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