Adenomatoid tumor of the testis mimicking malignant testicular cancer on multiparametric ultrasound

Abstract

BackgroundAdenomatoid tumor is one of the most common histological subtypes of paratesticular cancer arising from the epididymis. In very rare cases, these tumors appear as intratesticular lesions originating in the tunica albuginea, representing a diagnostic challenge.Case presentationWe present a case of a 51-year-old man with a small (0.9 cm) hyperechoic lesion of the left testicle mimicking testicular cancer on multiparametric ultrasound. The lesion was localized in the peripheral zone, confirming vascularization and increased stiffness on contrast-enhanced ultrasound and real-time elastography. Preoperative tumor markers and hormone levels were within normal ranges. Staging computed tomography was negative. Organ-sparing surgery with tumor enucleation and frozen section analysis was performed, confirming testicular adenomatoid tumor.ConclusionCurrently, no typical ultrasound features can definitively distinguish intratesticular adenomatoid tumors from malignant testicular masses. Thus, a surgical approach is almost always considered in such a case for both diagnostic and therapeutic purposes.

The Application Value of Contrast-Enhanced Ultrasound in Testicular Occupied Lesions

“…Two testicular hematomas did not show any enhancement on CEUS. It is not difficult to make a conclusion combined with trauma history, which provides strong evidence for the clinical diagnosis of testicular injury and the determination of injury types [ 24 ].…”

Paratesticular lesions: Aetiology and appearances on ultrasound

“…36 The enhancement of these lesions on CEUS, in combination with increased stiffness on elastography, has been reported in the setting of multi-parametric US. 47 A hydrocele may accompany this type of tumour, reported in up to 20% of cases. 6…”

“…Rarely, these tumours originate from the tunica albuginea and follow an intratesticular mode of expansion, mimicking a testicular neoplasm. 47 On colour Doppler US, adenomatoid tumours typically show no increased blood flow, except for larger tumours which may demonstrate some vascularity. 11,36 A CEUS examination is a more sensitive for the investigation of adenomatoid tumours, demonstrating increased enhancement similar or higher than the adjacent testis.…”

“…Adenomatoid tumours affect the epididymal tail four times more frequently than the head, but can be found in any aspect of the epididymis, the spermatic cord or the tunica vaginalis. Rarely, these tumours originate from the tunica albuginea and follow an intratesticular mode of expansion, mimicking a testicular neoplasm 47 . On colour Doppler US, adenomatoid tumours typically show no increased blood flow, except for larger tumours which may demonstrate some vascularity 11,36 .…”

Adenomatoid tumor of fallopian tube with intratumoral endometriosis: what mind doesn’t know, eyes don’t see

“…The common sites include the tunica vaginalis of testis, epididymis, small intestine, pancreas, appendix, and mediastinum. [2][3][4][5] In the female genitourinary tract, it most commonly involves the fallopian tubes, broad ligaments, and uterus involving the serosal, subserosal, and intramural aspect. [6][7][8][9][10]…”