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Congress: ECR24
Poster Number: C-14958
Type: EPOS Radiologist (educational)
DOI: 10.26044/ecr2024/C-14958
Authorblock: B. Rato, C. B. Saraiva, S. C. Lopes, P. Gomes, P. Donato; Coimbra/PT
Disclosures:
Beatriz Rato: Nothing to disclose
Carlos Bernardo Saraiva: Nothing to disclose
Simão Carvalho Lopes: Nothing to disclose
Paula Gomes: Nothing to disclose
Paulo Donato: Nothing to disclose
Keywords: Genital / Reproductive system male, Soft tissues / Skin, Ultrasound, Diagnostic procedure, Localisation, Cysts, Hernia, Neoplasia
Learning objectives To provide an image-based review of extratesticular scrotal masses and pseudomasses by anatomical compartments. To discuss the origin, clinical aspects and management of these lesions.
Read more Background Ultrasound imaging plays an essential role in the evaluation of palpable scrotal masses, which are a significant source of concern for both patients and physicians.The extratesticular space is the most common site for scrotal lesions. Its complex anatomy, stemming from diverse embryological origins, gives rise to numerous potential diagnoses, contributing to diagnostic uncertainty. While most of extratesticular lesions are benign, malignancies can also arise, along with their mimics. Recognizing specific characteristic imaging features and integrating them with factors such as...
Read more Findings and procedure details ANATOMYThe extratesticular space encompasses structures such as: Scrotal wall: Comprised of skin, dartos muscle, external spermatic fascia, cremasteric fascia and internal spermatic fascia. Except for dartos, these components extend centrally to join the spermatic cord. Tunica vaginalis: Formed by the testes' embryonic descent through the abdominal wall as a sock-like peritoneal evagination. Epididymis: A highly coiled, epithelial-lined tube surrounded by smooth muscle. Tunica albuginea: A fibrous covering of the testis that extends posteriorly, forming the mediastinum testis. Spermatic cord: Comprising three arteries (testicular, deferential, cremasteric),...
Read more Conclusion The majority of extratesticular lesions are benign, with epididymal cysts and spermatoceles being the most common. Among solid lesions, malignancy incidence increases, but benign entities such as adenomatoid tumors, epidermoid cysts, fibrous pseudotumors and epidermal inclusion cysts still prevail. Suspicion for malignancy must be particularly higher at the spermatic cord level, especially when lesions do not clearly resemble hernias or lipomas.An adequate diagnosis is essential to minimize unnecessary surgical interventions while also avoiding the misdiagnosis of malignant lesions.
Read more References Akbar, S. A., Sayyed, T. A., Jafri, S. Z. H., Hasteh, F., & Neill, J. S. A. (2003). Multimodality Imaging of Paratesticular Neoplasms and Their Rare Mimics. RadioGraphics, 23(6), 1461–1476. https://doi.org/10.1148/rg.236025174 Gabriel, H., Hammond, N. A., Marquez, R. A., Lopes Vendrami, C., Horowitz, J. M., Casalino, D. D., Nikolaidis, P., Miller, F. H., & Bhatt, S. (2023). Gamut of Extratesticular Scrotal Masses: Anatomic Approach to Sonographic Differential Diagnosis. RadioGraphics, 43(4). https://doi.org/10.1148/rg.220113 Hertzberg, B. S., & Middleton, W. D. (2015). Ultrasound: The Requisites....
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