Adenomatoid tumors of the scrotum
Updates to Article Attributes
Adenomatoid tumours of the scrotum are benign, solid extratesticular lesions that can originate from the epididymis, tunica vaginalis, or spermatic cord (90% derived from the funiculus).
Epidemiology
They are the most common extratesticular neoplasm, and most common tumour of the epididymis, and occur more often in the lower pole than in the upper pole by a ratio of 4:1.
Clinical presentation
Usually an incidental finding, adenomatoid tumours manifest as a small (usually under 2 cm), painless scrotal mass, with the majority diagnosed in patients aged 20-50 years. They are typically unilateral and occur more frequently on the left side.
When they grow non-invasively into the testicular parenchyma, they can simulate intratesticular disease.
Radiographic features
Ultrasound
- well-defined
solid, usually oval extratesticular mass with variable echogenicity although most are isoechoic to the epididymis 6 - usually solid although can be completely cystic 6
- range in size from a few millimetres to a few centimetres
MRI
MR imaging can aid in determining the paratesticular origin of the lesion.
Signal characteristics
- T2: low signal intensity relative to the testicular parenchyma
- T1 C+ (Gd): show enhancement
Treatment and prognosis
They are benign with no reports of recurrence or metastatic disease after excision 5,6.
Differential diagnosis
General imaging differential considerations include:
- peritesticular lipoma
- peritesticular rhabdomyosarcoma
- peritesticular liposarcoma
-
supernumerary testes
- : a rare condition in which more than two testes are present
- epididymitis
- scrotal tuberculosis
See also
-<li>well-defined solid extratesticular mass with variable echogenicity</li>- +<li>well-defined, usually oval extratesticular mass with variable echogenicity although most are isoechoic to the epididymis <sup>6</sup>
- +</li>
- +<li>usually solid although can be completely cystic <sup>6</sup>
- +</li>
-</ul><h5>MRI</h5><p>MR imaging can aid in determining the paratesticular origin of the lesion.</p><ul>- +</ul><h5>MRI</h5><p>MR imaging can aid in determining the paratesticular origin of the lesion.</p><h5>Signal characteristics</h5><ul>
-</ul><h4>Treatment and prognosis</h4><p>They are benign with no reports of recurrence or metastatic disease after excision <sup>5</sup>.</p><h4>Differential diagnosis</h4><p>General imaging differential considerations include:</p><ul>-<li><a title="Peritesticular lipoma" href="/articles/peritesticular-lipoma">peritesticular lipoma</a></li>- +</ul><h4>Treatment and prognosis</h4><p>They are benign with no reports of recurrence or metastatic disease after excision <sup>5,6</sup>.</p><h4>Differential diagnosis</h4><p>General imaging differential considerations include:</p><ul>
- +<li><a href="/articles/peritesticular-lipoma">peritesticular lipoma</a></li>
-<a href="/articles/polyorchidism">supernumerary testes</a><ul><li>a rare condition in which more than two testes are present</li></ul>-</li>- +<a href="/articles/polyorchidism">supernumerary testes</a>: a rare condition in which more than two testes are present</li>
References changed:
- 6. Syed Ali Akbar, Tawfeeq Amjadali Sayyed, Syed Zafar Hasan Jafri, Farnaz Hasteh, James Simeon Adams Neill. Multimodality Imaging of Paratesticular Neoplasms and Their Rare Mimics1. (2003) RadioGraphics. <a href="https://doi.org/10.1148/rg.236025174">doi:10.1148/rg.236025174</a> <span class="ref_v4"></span>
Unable to process the form. Check for errors and try again.