The patient was assessed for testicular carcinoma markers, which was negative. Semen analysis was within normal limits. In view of sonographic features, the patient was advised for follow-up. The patient is not willing for any surgical intervention at present. A provisional diagnosis of intratesticular AV malformation was considered, in view of the predominantly vascular intratesticular lesion, with doppler features of AV malformation. While arterial feeders demonstrate low resistance arterial flow, draining channels are compressible, though pure venous waveform could not be appreciated.

The essential differential diagnosis to be considered is intratesticular varicocele, which will have a venous waveform.