Sonography of Scrotal Wall Lesions and Correlation With Other Modalities

Abstract

The scrotal wall may be involved in a variety of pathologic processes. Such lesions may rise primarily from the layers of the scrotum or may be due to a process arising from scrotal content. Imaging is not needed in most cases, but it may be useful for making such differentiations and for evaluation of possible involvement of the testes and epididymides in cases of primary wall abnormalities. This pictorial essay will show the imaging findings observed in a variety of pathologic conditions affecting the scrotal wall, both common and unusual ones, with an emphasis on clinically relevant findings and features that lead to a specific diagnosis.

Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations

“…Patients presenting with uncommon conditions [ 170 , 171 ], as well as patients with extratesticular cavernous haemangiomas, lymphangiomas, and arteriovenous malformations can present with a non-specific diagnosis, or with suspicion of a varicocele based on their clinical presentation [ 172 – 174 ]. Although MRI is the modality of choice for delineating the extent of these abnormalities, in clinical practice, the diagnosis is usually obtained with US.…”

“…The lesion and serpiginous vessels show enhancement after contrast medium administration. Focal signal voids may be seen, consistent with thrombi [ 172 , 173 ]. Lymphangiomas are composed of dilated lymphatic channels,they may present as lobulated cystic masses or with findings similar to those of haemangiomas.…”

“…The dilated lymphatic channels of lymphangiomas do not enhance after contrast medium injection. Lymphangiomas present on MRI as lobulated scrotal masses with intermediate-to-low signal intensity on T1-weighted images and high signal intensity on T2-weighted images [ 172 ]. Arteriovenous malformations are characterized by abnormal connections between arteries and veins.…”

Diagnosis and Management of Scrotal Wall Mass with the Aid of Scrotoscope: Case Series Report

“…Ultrasonography is the most common diagnostic test for intrascrotal masses, which has a moderately good diagnostic value to its nature, but relatively low diagnostic value to its exact location 1,10 . As showed by our study, ultrasonography precisely diagnosed the cyst nature of 3(50%) scrotal wall masses and roughly describe the benign appearance of the other 3 scrotal wall masses.…”

“…The scrotal wall could be involved in various primary and secondary pathological processes, which might lead to a large variety of lesions 1 . In fact, scrotal wall mass is relatively rare in clinical practice, and very di cult to be differentiated from scrotal content lesions by physical or ultrasound examination, which brought us a certain degree of trouble to make an appropriate therapeutic regiment.…”