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Epididymo-orchitis with background microlithiasis

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Three days of right testicular pain and fevers.

Patient Data

Age: 50 years
Gender: Male

The right testis measures 23 mL and the left measures 14 mL. The right testis has a striated appearance. Marked bilateral testicular microlithiasis. The left testis demonstrates otherwise normal, uniform echotexture. There is no focal mass in either testis.

The right epididymis is asymmetrically enlarged and hypervascular when compared to the left.

Bilateral hydroceles, larger on the right, with internal septations.

Case Discussion

Classic findings of epididymo-orchitis on the right:

  • enlarged testis and epididymis
  • hypervascular
  • striated appearance

Background testicular microlithiasis, which is usually incidental but may have an associated with germ cell tumors. 

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