Document Detail

Acute scrotal pain with a twist.
MedLine Citation:
PMID:  20529466     Owner:  NLM     Status:  MEDLINE    
Intratesticular lesions identified on ultrasound are usually malignant. It presents a particular dilemma to the surgeon when conservative approach is considered. A 55-year-old smoker with peripheral vascular disease had attended the accident and emergency with acute left hemiscrotal pain of 24-h duration. Clinical examination revealed a swollen, tender hemiscrotum. Ultrasound had demonstrated a hypo-echoic lesion in the testis measuring 2 x 1.8 cm. This was reported as possible infarct and managed conservatively. On review after 4 weeks, the patient was still symptomatic with persistent dull pain. A repeat scan in 4 weeks showed persistence of the lesion raising the possibility of tumour. Tumour marker profile was not elevated. The patient had a radical orchidectomy and the histology showed segmental infarction of the testis with thrombosis of the segmental testicular vessels. Peripheral vascular disease can cause segmental infarction of the testis due to the end arterial blood supply; in these cases, magnetic resonance scan can be diagnostic. Once confirmed, segmental infarcts can be safely managed conservatively.
S Venugopal; D Schoeman; A Damola; B Hamid; C Powell
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-06-07
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  92     ISSN:  1478-7083     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-14     Completed Date:  2010-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  England    
Other Details:
Languages:  eng     Pagination:  W24-6     Citation Subset:  IM    
Department of Urology, Countess of Chester NHS Trust, Chester, UK.
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MeSH Terms
Acute Disease
Diagnosis, Differential
Infarction / diagnosis*,  surgery
Middle Aged
Pain / etiology*
Testicular Neoplasms / diagnosis
Testis / blood supply*

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