Longitudinal view of the left testicle showing a lobulated mass with a density slightly lower than the rest of the testicle.
The mass shows a marked hypervascularity compared to the rest of the testicle.
Transverse image of the testicular mass.
Because a vascularized non tender testicular mass in a 31 year old male is highly suspicious of malignancy, the patient was operated.
To everyone's surprise the mass was not malignant, but was a splenogonadal fusion. The hypervascularized lesion is splenic tissue within the testicle. It is a benign uncommon abnormality, especially when found in an adult.
When a vascularized testicular mass is found in children, it is good to think about this entity because the treatment is not the same as with malignant lesions. In case of a splenogonadal fusion tumorectomy can be performed with preservation of the testicle. Especially when a lesion is hypo or avascular a testicular lesion is not always malignant.
This hypoechoic lesion in the testicle of a 20 year old male was also benign and was a Leydig´s cell tumor.
This lobulated testicular lesion in a 32 year old patient with mixed echogenicity, without vascularization, appeared to be a hemorrhagic chronic inflammation.
However testicular lesions, especially when they are vascularized, should always be considered suspicious of malignancy until proven otherwise.