Segmental testicular infarction

BackgroundSegmental testicular infarction is a very rare condition, which can mimic a testicular torsion or testicular cancer. Correct diagnosis is difficult but it is important to avoid unnecessary radical treatment.Case presentationWe report a clinical case of a 36-year-old white man who presented at our emergency department with subacute testicular pain. A urine analysis, Doppler ultrasound, surgical exploration, blood analysis, and magnetic resonance imaging were performed to diagnose his condition, to exclude a testicular torsion, and to raise confidence in its non-malignancy. He was treated conservatively. At follow-up, a few months after the incident, he no longer had complaints. Ultrasonography showed remaining hypo-echogenicity of the left upper pole, indicating a sequel of ischemia.ConclusionsSegmental testicular infarction is a rare condition which can be easily confused with a testicular torsion or a testicular tumor. This case report can be helpful in recognizing and diagnosing this condition. Making the right diagnosis is important since it can prevent an unnecessary radical treatment.

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“…Abdominal pain can be present too. Palpation of the testicle is usually normal; however, an induration can be felt in more advanced cases [6]. …”

Section: Discussionmentioning

confidence: 99%

Segmental testicular infarction: a case report

Smets

Reichman²,

Michielsen³

2017

J Med Case Reports

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“…The differential diagnosis of STI are testicular hematoma, epidermoid cyst, orchitis with or without abscess, adrenal rests, sarcoidosis, sex cord-stromal tumor, lymphoma and germ cell tumors of the testis that in 55% of the cases accounts for testicular seminoma. The common finding of all these entities is that at US evaluation are described as well-rounded hypoechoic lesions with or without arterial flow at Doppler US and without elevation of tumor markers that often misleads the diagnosis towards testicular seminoma [1,3,5]. Segmental testicular infarction is an unusual diagnosis and it is often confused with testicular neoplasm, fewer than 50 cases have been reported, the current standard for diagnosis is US, magnetic resonance imaging (MRI) showed no advantage over US evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…spermatic artery, hypercoagulability disorders and sickle cell disease [1][2][3][4]. Usually occurs between the third and fourth decade of life, the most common symptom is acute onset orchialgia; Scrotal US remains the first assessment tool, it is described as a wedge-shaped or rounded area of hypoechogenicity within the testis, at doppler evaluation with markedly decreased or absent, although it could have well preserved flow and negative tumor markers, mimicking testicular seminoma [1,3]. We aim to present the case of a 33 year-old male with presumptive diagnosis of testicular seminoma, with upper pole STI confirmed by microscopic pathological evaluation.…”

mentioning

confidence: 99%