PMC4720173_01
An ultrasound image shows a mild hydrocele with several soft-tissue nodules arising from the tunica vaginalis (arrow heads) and a solid mass (asterisk) adjacent to the testis. Note that the mass is isoechoic compared with the testis and shows posterior acoustic shadowing. T=testis.
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Additionally, there were also flat nodular lesions measuring 7x3 mm, 3x2.5 mm, and 2.5x2 mm on the anterior scrotal wall, which originated from the tunica vaginalis (Figure 1).
PMC4720173_02
(A) Longitudinal panoramic view of scrotal ultrasonography demonstrates a heterogeneous well-circumscribed hypoechoic mass (asterisk) in the infratesticular region. E=epididymis, T=testis. (B) The mass shows prominent posterior shadowing (arrows). (C) An axial T2-weighted MR image depicts a markedly hypointense nodular lesion. It is surrounded by a high-signal-intensity hydrocele. (D)Two nodular lesions (arrowheads) with moderate contrast enhancement are seen in an abdominopelvic CT scan.
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A sonographic examination revealed a solid mass lesion with a smooth contour and an ovoid morphology, which measured 20x17 mm and had a posterior acoustic shadowing adjacent to the lower pole of the left testis (Figure 2A, 2B). T2W series while it appeared mildly hypointense compared to testis on T1W series (Figure 2C). The post-contrast images showed mild heterogeneous contrast uptake. A CT examination with contrast obtained for another reason demonstrated diffuse contrast uptake of mild-to-moderate degree (Figure 2D).
PMC4720173_03
(A) An ultrasound image of the right scrotum reveals nodular lesions (arrowheads) projecting off the tunica vaginalis of the anterior wall into the scrotal fluid. T=testis. (B) Increased vascularity is seen around the pedicle of the dominant nodule on a color Doppler image. Axial MR images show multiple small nodular lesions, which are hypointense on T1-weighted image (C) and markedly hypointense on T2-weighted image (D); on contrast-enhanced image (E), the lesions have more intense enhancement than the normal testis.
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A scrotal US examination showed mild hydrocele and multiple solid nodular lesions, with the largest measuring 16x9.5 mm, which originated from the tunica vaginalis and appeared slightly hypoechoic compared with the testis (Figure 3A). CDUS examination characterized vascularity of moderate degree in the lesions (Figure 3B). MR examination showed that all lesions had a hypointense appearance compared with the testis on both T1W and T2W series (Figure 3C, 3D). On postcontrast images all lesions were characterized by marked diffuse contrast uptake (Figure 3E).