A 16-year-old male presented with a painless right testicular mass, known for the past 2 years and that had recently increased in size. Physical examination confirmed a hard testicular mass and no evidence of lymphadenopathy or of gynecomastia. Laboratory results, including tumor markers, were normal. Ultrasound (US) revealed a solid mass in the upper pole of the right testis that was well circumscribed, avascular, and displayed the onionskin appearance suggestive of testicular epidermoid cyst (1,2) ( Figure-1).Magnetic resonance (MR) confirmed the well-circumscribed intra-testicular mass with a A B

Teaching Point : Primary breast angiosarcoma should be in the differential of a breast mass with rapid growth. It typically appears intensely vascularized and non-calcified, predominantly hyperechoic, and hyperintense on T2-weighted MRI.

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Background The burden perceived by the patient of repeated imaging required for neoadjuvant chemotherapy (NAC) monitoring warrants attention due to the increased use of NAC and imaging. Purpose To evaluate and compare the experienced burden associated with repeated contrast-enhanced mammography (CEM) and magnetic resonance imaging (MRI) during NAC for breast cancer from the patient perspective. Material and Methods Approval from the ethics committee and written informed consent were obtained. In this prospective study, CEM and MRI were performed on 38 patients with breast cancer before, during, and after NAC in a tertiary cancer center. The experienced burden was evaluated with a self-reported questionnaire addressing duration, comfort, anxiety, positioning, and intravenous contrast administration, each measured on a 5-point Likert scale. The participants were asked their preference between CEM or MRI. Statistical comparisons were performed and P<0.05 was considered significant. Results Most participants (n = 29, 76%) preferred CEM over MRI ( P = 0.0008). CEM was associated with a significantly shorter duration ( P < 0.001), greater overall comfort ( P < 0.01), more comfortable positioning ( P = 0.01), and lower anxiety ( P = 0.03). Intravenous contrast administration perception revealed no significant difference. Only 4 (10%) participants preferred MRI over CEM, due to the absence of breast compression. Conclusion In the hypothetical scenario of equal diagnostic accuracy, most participants preferred CEM and compared CEM favorably to MRI in all investigated features at repeated imaging required for NAC response assessment. Our results indicate that repeated examinations with CEM is well tolerated and constitutes a patient-friendly alternative for NAC imaging monitoring in breast cancer.