Adenomatoid tumors of the scrotum

Changed by Amir Rezaee, 25 Oct 2015

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Adenomatoid tumours of the scrotum are benign, solid extratesticular lesions that can originate from the epididymis, tunica vaginalis, or spermatic cord (90% derived from the funiculus).

Epidemiology

They are the most common extratesticular neoplasm, and most common tumour of the epididymis, and occur more often in the lower pole than in the upper pole by a ratio of 4:1.

Clinical presentation

Usually an incidental finding, adenomatoid tumours manifest as a small (usually under 2 cm), painless scrotal mass, with the majority diagnosed in patients aged 20-50 years. They are typically unilateral and occur more frequently on the left side.

When they grow non-invasively into the testicular parenchyma, they can simulate intratesticular disease.

Radiographic features

Ultrasound

well defined solid extratesticular mass with variable echogenicity
range in size from a few millimeters (mm) to a few centimeters (cm)

MRI

MR imaging can aid in determining the paratesticular origin of the lesion.

T2: low signal intensity relative to the testicular parenchyma
T1 C+ (Gd): show enhancement

Treatment and prognosis

They are benign with no reports of recurrence or metastatic disease after excision ⁵.

Differential diagnosis

General imaging differential considerations include:

~~testicular~~peritesticular lipoma
~~testicular~~peritesticular rhabdomyosarcoma
~~testicular~~peritesticular liposarcoma
supernumerary testes (a rare condition in which more thantwo testes are present)

~~-<li><a href="/articles/testicular-lipoma">testicular lipoma</a></li>~~
~~-<li><a href="/articles/testicular-rhabdomyosarcoma">testicular rhabdomyosarcoma</a></li>~~
~~-<li><a href="/articles/testicular-liposarcoma">testicular liposarcoma</a></li>~~
+<li><a href="/articles/testicular-lipoma">peritesticular lipoma</a></li>
+<li><a href="/articles/testicular-rhabdomyosarcoma">peritesticular rhabdomyosarcoma</a></li>
+<li><a href="/articles/testicular-liposarcoma">peritesticular liposarcoma</a></li>

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