Scrotal mass differential diagnosis

Scrotal Mass Microchapters
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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]

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.

Disease Name	History and Symptoms	Physical Examination	Lab Findings	Imaging Findings	Gross and Histologic Findings	Genetic Studies / Immunohistochemistry
Germ Cell Tumors
Seminoma	Most common 30-50 year-old with painless unilateral testicular mass or mild discomfort	Palpable, nontender unilateral testicular mass Usually homogeneous enlargement	Elevated serum placental ALP (PALP)	Hypoechogenic intratesticular well-defined mass on ultrasound with internal blood flow on Doppler ultrasound Cysts and calcificications are uncommon Hypointense lesion with inhomogeneous enhancement on MRI Homogeneous when small and heterogeneous when large	Grey-white homogeneous mass with a lobular appearance Fried egg appearance on histopathology (large cells and clear cytoplasm) Prominent lymphocytic infiltration and less commonly, granulomatous formation	Stains positively for ALP, c-KIT, CD30, EMA, and glycogen
21	22	23	24	25	26	27
B
C
D