The diverse embryological origins of the contents of the scrotum create an environment that fosters a wide variety of unusual pathologies. Most scrotal pathologies are discovered by the patient and are initially evaluated by a thorough physical examination and scrotal ultrasonography. Scrotal lesions can be broadly grouped by the anatomical location in which they develop; the clinician must consider a wide differential diagnosis based on this location. Solid testicular masses are considered germ cell tumors until proven otherwise, but numerous other possible pathologies exist, including ectopic tissue, metastasis, and other neoplastic growths. Rete testis lesions are classified as developmental, benign or malignant. Cystic lesions of the epididymis are most commonly benign, but malignant neoplasms can also be present. The paratesticular region has the broadest differential diagnosis, as it contains numerous distinct structures and is a common location for ectopic tissue and metastatic disease; a narrower range of lesions develop in the scrotal wall because of its simpler anatomy. Treatment options range from conservative observation to wide surgical excision and should be considered carefully; the aim of therapy is to remove malignant or potentially malignant tissue while minimizing effects on fertility and function.
[Show abstract][Hide abstract] ABSTRACT: Epididymal tumours are rare, but definite pathological entity. Most tumours are benign, however, malignant lesions have also been reported. The common benign tumours are either leiomyomas or adenomatoid tumours. Malignant pathologies include primary epididymal adenocarcinoma, liposarcoma, leiomyosarcoma, malignant fibrous histiocytoma, mesothelioma and lymphoma. We present a case of a 45-year-old male referred urgently for suspected scrotal mass which on ultrasonography showed a lesion in the left epididymal head (possible granuloma).
Canadian Urological Association journal = Journal de l'Association des urologues du Canada 12/2011; 5(6):E113-5. DOI:10.5489/cuaj.11028 · 1.92 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Nonosseous Ewing sarcoma commonly occurs in the extremities or deep soft tissues. However, cutaneous and subcutaneous locations have been reported. A 3-year-old boy presented with a 2-year history of a painless, slowly growing mid-scrotal mass. Pathology after surgical excision revealed the lesion to be Ewing sarcoma. The patient is free of metastatic disease and is currently undergoing chemotherapy. Soft-tissue malignancies must be kept in the differential diagnosis of any solid paratesticular mass in a child. Although rhabdomyosarcoma is the most common, as this case demonstrates, other rare sarcomas are also possible.
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