Presentation
Empty left hemiscrotum.
Patient Data
Empty left hemiscrotum.
Oval testis-like structure is noted at the pelvis adjacent, and medial, to the left external iliac vessels just lateral to the urinary bladder, measuring about 3 x 2 x 2 cm.
The right testis is seen within the right hemiscrotum, showing normal signal intensity with no focal lesions seen. It measures 5.5 x 3.5 x 3.0 cm.
Small volume inguinal nodes.
Incidentally noted, midline 1.5 cm prostatic cyst, most likely a utricle cyst.
Case Discussion
This case represents an undescended left testis, lying within the pelvic cavity, just medial to the ipsilateral external iliac vessels with normal MRI features of the right testis within its respective hemiscrotum. MRI is the optimal cross-sectional modality to assess cryptorchidism. Diffusion-weighted MRI shows diffusion restriction of the undescended testis, and helps to differentiate it from surrounding structures. An enlarged inguinal or intra-abdominal lymph node may be mistaken for the ectopic testis on ultrasound, although a skilled sonographer can usually differentiate between the two.
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