Segmental testicular infarction: Case series and brief literature review of a great mime

Abstract

Segmental testicular infarction is rare, and the etiology is mostly idiopathic. We report a case series of four young patients, one of them with metachronous bilateral disease, presenting with an acute scrotum and treated with a testis-sparing approach, if feasible, after a negative intraoperative biopsy. Etiology, differential diagnosis, and management are reviewed. To be aware of clinical and imaging features of this benign testicular pathology, it is crucial to avoid unnecessary orchiectomies to preserve vital testicular tissue left.

Scrotal Pain Caused by a Segmental Testicular Infarct

“…While most cases are idiopathic, it is associated with vasculitis, sickle cell disease, trauma, torsion, infection, malignancy, and polycythemia. 1,2 In this case, it is likely the patient's use of steroids and subsequent polycythemia were the cause of his infarct given the lack of other risk factors. The use of anabolic steroids is known to contribute to polycythemia and increase the risk of thrombosis and ischemic events.…”

Segmental testicular infarct with an associated testicular artery aneurysm: Case report of a rare clinical entity

“…The age distribution is later than the classic testicular infarction/testicular torsion and is seen in the 2nd-fourth decades of life. Most cases are idiopathic, although associations with epididymo-orchitis, intermittent testicular torsion, vasculitis, sickle cell disease, hypercoagulable states, trauma, polyarteritis nodosa, diabetic microangiopathy, embolic disease, and previous surgery (hernia repair, varicocelectomy, vasectomy, cysto-prostatectomy) have been documented [5] , [6] , [7] , [13] , [14] , [15] , [16] , [17] , [18] ]. Interestingly, an extensive work up of our patient was negative for these associated conditions.…”

MRI-guided conservative management of a left segmental testicular infarction

“…STI is uncommon in patients over 50 years; this typically occurs in 20- to 40-year-olds [1 , 2] . Patients generally present with pain in the scrotal region [4] .…”

“…Although STI is idiopathic in nature, it is associated with epidymoorchitis, sickle cell anemia, vasculitis, hypercoagulable states such as antithrombin III or protein S deficiency, venous thrombosis, folate metabolism disorder, homocysteine elevation, surgery of inguinal hernia, and varicocele [1] , [2] , [3] .…”

“…Partial testicular infarction is a unique condition that is mostly idiopathic in nature [1] , [2] , [3] . Clinically, it resembles torsion and testicular tumors, thus making it difficult for urologists to observe or perform surgery [1] , [2] , [3] , [4] . In this case report, we illustrate how radiological investigations can allow the patient to be safely monitored without intervention.…”