Scrotal mass differential diagnosis
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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.[1][2]
| Scrotal Swelling | Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Associated | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | ||||||
| Epididymoorchitis | Unilateral | Gradual | ± | Dysuria, frequency, and/or urgency | + | _ | Hydrocele | Acute infection is characterized by infiltration of neutrophils. Chronic cases of epididymoorchitis, such as in sarcoidosis or tuberculosis, are characterized by granulomatous inflammation. | ||||||||
| Testicular Torsion | Unilateral | Sudden | - | + | ||||||||||||
| Torsion of testicular appendix | + | |||||||||||||||
| 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
- ↑ Unilateral testicular lesions. Dr Yuranga Weerakkody and Dr Vinod G Maller et al. Radiopaedia 2016. http://radiopaedia.org/articles/unilateral-testicular-lesions. Accessed on March 15, 2016
- ↑ Bilateral testicular lesions. Radiopaedia 2016. Dr Matt A. Morgan and Dr Vinod G Maller et al. Radiopaedia 2016. http://radiopaedia.org/articles/bilateral-testicular-lesions. Accessed on March 15, 2016