Scrotal mass differential diagnosis: Difference between revisions
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* Previous history of [[testicular torsion]] | * Previous history of [[testicular torsion]] | ||
* [[Family history]]<nowiki/>of [[testicular torsion]] | *<nowiki/>[[Family history]]<nowiki/> of [[testicular torsion]] | ||
* [[Prematurity]] | * [[Prematurity]] | ||
* [[Undescended testes]] | *<nowiki/>[[Undescended testes]] | ||
* [[Low birth weight]] | * [[Low birth weight]] | ||
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| 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 | | style="background: #F5F5F5; padding: 5px;" |Absent or decreased arterial perfusion of the testis | ||
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* [[Prematurity]] | |||
* [[Undescended testes]] | |||
* [[Low birth weight]] | |||
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Revision as of 18:14, 23 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
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 testicular lymphoma (usually non-Hodgkin lymphoma).
Differential Diagnosis
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 Swelling | Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Associated | |||||||||||
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Painful | Symptoms | Physical examination | ||||||||||||||
Lab Findings | Past Medical History | Histopathology | ||||||||||||||
Unilateral /Bilateral swelling | Onset | Fever | Urinary symptoms | Tenderness | Erythema | Discharge | Inguinal Lymphadenopathy | Cremasteric Reflex | Urine Analysis | Doppler U/S | ||||||
Epididymitis[1] | Unilateral | Gradual | ± | Dysuria, frequency, and/or urgency | + | _ | Pyuria | + | Hydrocele |
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Orchitis | Unilateral or bilateral | Abrupt | ± | ± | + | _ | ± | + | Leukocytosis |
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Testicular Torsion[2] | Unilateral | Sudden | - | + | + | Blood in semen | _ | Normal | Absent or decreased arterial perfusion of the testis |
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Torsion of testicular appendix | Unilateral | Sudden | - | + | + | _ | _ | Normal | Absent or decreased arterial perfusion of the testis | prepubertal period | ||||||
Hematocele | + | |||||||||||||||
Incarcerated Hernia | - | |||||||||||||||
Testicular Abcess | - | |||||||||||||||
Brucellosis | - | |||||||||||||||
Mumps | - | |||||||||||||||
Histoplasma | ||||||||||||||||
Gonorrhea | ||||||||||||||||
Fournier's gangrene | ||||||||||||||||
Scrotal Swelling | Diseases | Unilateral /Bilateral swelling | Lab 3 | Fever | Urinary symptoms | Tenderness | Erythema | Discharge | Inguinal Lymphadenopathy | Cremasteric Reflex | Urine Analysis | Doppler U/S | Past Medical History | Histopathology | Gold standard | Additional findings |
Painless | Fragile XMacroorchidism | - | + | |||||||||||||
Testicular Tumors | - | + | ||||||||||||||
Henoch-Schonlein purpura | - | - | ||||||||||||||
Hydrocele | - | - | ||||||||||||||
Varicocele | - | - | ||||||||||||||
Spermatocele | - | - | ||||||||||||||
Inguino-scrotal hernia | - | - | ||||||||||||||
Scrotal edema | - | - | ||||||||||||||
Epididymal cyst | ||||||||||||||||
Scrotal oedema | ||||||||||||||||
Sebaceous cyst | ||||||||||||||||
Carcinoma of the scrotum | ||||||||||||||||
Chylocele (Filariasis) | ||||||||||||||||
Cystic dysplasia | ||||||||||||||||
Srotoliths |
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.
- ↑ 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.