Acute segmental testicular infarction: differentiation from tumour using high frequency colour Doppler ultrasound

Abstract

Segmental testicular infarction is rare, of variable aetiology but usually idiopathic. B-mode ultrasound may demonstrate a focal mass indistinguishable from a testicular tumour, with confirmation only achieved following surgery. We report a case of segmental testicular infarction presenting as a heterogeneous mass on B-mode ultrasound, confidently diagnosed as an area of infarction on high frequency colour Doppler ultrasound and proven on histology. The pre-operative differentiation of tumour from segmental infarction allows testis-sparing surgery.

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“…There has been reported some variable manifestations in the B-mode US of segmental infarction, a low reflective area with no acoustic enhancement posteriorly or a segmental reflective mass with sacks of low reflectivity. In this case making the differential diagnosis was troublesome given the CDUS reported normal flow to the testis and within the hypoechoic area described at US evaluation; while we were unable to provide an alternative etiology to testicular seminoma, radical orchiectomy was indicated [6,7].…”

Segmental Testicular Infarction: Case Series and Literature Review of a Rare Diagnosis in Men with Acute Testicular Pain

“…Segmental testicular infarctions (STI) are rare, mostly idiopathic in origin and often diagnosed only after a surgical and histological examination [1].…”

Metachronous bilateral segmental testicular infarction: multi-parametric ultrasound imaging with grey-scale ultrasound, Doppler ultrasound, contrast-enhanced ultrasound (CEUS) and real-time tissue elastography (RTE)

“…The sonographic appearances are variable, both wedge-shaped and rounded lesions have been described, and may mimic a primary germ cell tumour of the testis [1]. Distinguishing a segmental infarction from a tumour is of critical importance in order to avoid unnecessary orchiectomy [2]. Newer techniques of contrastenhanced ultrasound (CEUS) [3] and real-time tissue elastography (RTE) [4] are being used to aid in the differentiation of indeterminate intra-testicular abnormalities [5,6].…”