Testicular torsion - neonatal, delayed

Case contributed by Alexandra Stanislavsky
Diagnosis certain

Presentation

Enlarged left testis at birth. Ultrasound performed 2 weeks later.

Patient Data

Age: 2 weeks
Gender: Male
ultrasound

The left testis is smaller than the right, with no internal vascularity.  It has a rim of peripheral calcification.  Right testis has normal appearance and vascularity, no calcification.  Incidentally, there is a right hydrocele.

Case Discussion

This case demonstrates established testicular infarction in a neonate with calcification of the tunica albuginea.  In retrospect, the history of left testicular enlargement at birth suggests an acute perinatal torsion with a delayed diagnosis.

Compare this case with a case of testicular torsion diagnosed at birth.  Despite markedly different appearances, the affected testis was non-viable at surgery in both cases.

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