Impalpable testis cancer
BJU International (Impact Factor: 3.53). 05/2004; 93(6):888. DOI: 10.1111/j.1464-410X.2004.4737d.x
Article: Testicular lumps[Show abstract] [Hide abstract]
ABSTRACT: • This article discusses the radiological anatomy of the testis and the clinical indications for scrotal ultrasound. • The morphological appearances of both common and rare testicular masses are described and illustrated. • Benign and malignant lesions of the epididymis are discussed • different forms of scrotal calcification are illustrated.
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ABSTRACT: The purpose was to analyse the aetiology and ultrasound appearances of segmental testicular infarction. Patients with focal testicular lesions underwent colour Doppler high frequency ultrasound. Segmental testicular infarction was defined as any focal area of altered reflectivity, with or without focal enlargement with absent or diminished colour Doppler flow, proven on histology or on follow-up exclusion of lesion progression. Patients were reviewed to document lesion shape, position, border definition, reflectivity and vascularity and correlated to presenting clinical symptoms and signs. Over a 6-year period 24 patients were defined as having segmental testicular infarction; median age was 37 years (range 16-82 years). All presented with a sudden onset of testicular pain. Of the patients, 14/24 (58.3%) had scrotal inflammatory disease, 5/24 (20.8%) had evidence of spermatic cord torsion, and three patients were termed idiopathic; 12/24 (50.0%) were of low reflectivity, 11/24 (45.8%) of mixed reflectivity, one of high reflectivity, 11/24 (45.8%) were wedge shaped, and 13/24 (54.2%) were round shaped. Of the patients, 8/24 (33.3%) demonstrated a mass effect, all with round-shaped lesions and with underlying epididymo-orchitis in seven. Absent colour Doppler flow was demonstrated in 20/24 (83.3%). Histology confirmed infarction in 8/24 (33.3%), and 12/24 (50.0%) had follow-up examinations without progression of the lesions. Segmental testicular infarction has characteristic ultrasound features, not always wedge-shaped, with reduced or absent vascularity of key importance. Awareness of the ultrasound features will allow for conservative management and avoid unnecessary orchidectomy.
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ABSTRACT: The twinkling artifact is a color Doppler phenomenon that appears as a rapidly fluctuating red and blue Doppler signal behind a strongly reflecting medium, manifesting as a color signal but without real flow behind the structures. To the untrained eye, the twinkling artifact may lead to the misdiagnosis of vascular flow within a structure. Our objective was to show the occurrence of the twinkling artifact in the testis. Two patients with calcification in the testis were examined with standard settings on 2 different sonography machines to show this artifact. Calcification in the tunica albuginea and intratesticular macrocalcification both showed this artifact. We report the presence of the twinkling artifact in 2 cases of testicular calcification, which shows that this phenomenon can occur in the testis.
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