PMC4898293_01
44-year-old male with Leydig-cell tumor. Sagittal sonogram of the right testis shows a 3-mm hypoechoic nodule (arrow).
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In the right testis, an oval, 3-mm hypoechoic lesion with a visible posterior wall, faint internal echoes, and no clear through-transmission was noted (Fig. 1).
44-year-old male with Leydig-cell tumor. Transverse color Doppler sonogram of the right testis focusing on the hypoechoic nodule demonstrates flow adjacent to the nodule, but not within the nodule (arrow).
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Color Doppler evaluation did not demonstrate internal blood flow, but marginal flow was detected (Fig. 2).
44-year-old male with Leydig-cell tumor. Sagittal T2-weighted MR image of the right testis (R) shows the 3 mm nodule (arrow) with decreased signal intensity compared to the remainder of the testis. An oblique section through the left testis (L) is included in the field of view. B. Sagittal, dynamic, gadolinium-contrast-enhanced MR image performed at 60 seconds following contrast injection shows the nodule to be hyperenhancing compared to the remainder of the right testis (R). The left testis (L) is partly included in the field of view.
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The MR examination revealed that the right testicular lesion was hypervascular relative to the background testicular enhancement at 60 seconds (Fig. 3A and B).
Intraoperative sagittal sonogram localizes the 3-mm nodule to the closest surface of the testis. B. Intraoperative sagittal sonogram performed after surgical removal of the nodule shows no residual mass.
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Intraoperative sonography of the right testis was requested for lesion localization, since the mass was not palpable even after the right testis was brought out through the right groin incision (Fig. 4A and B).