Sonographic findings in testicular sarcoidosis simulating malignant nodule

Eraso, Carmen E.; Vrachliotis, Thomas G.; Cunningham, Jerome J.

doi:10.1002/(sici)1097-0096(199902)27:2<81::aid-jcu6>3.0.co;2-n

Cited by 11 publications

(4 citation statements)

References 14 publications

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“…If splenogonadal fusion is suspected, 99m Tc sulfur colloid scans can confirm activity in ectopic splenic tissue (44). most commonly a focal hypoechoic mass lesion, similar to seminoma (41,42).…”

Section: Sarcoidosismentioning

confidence: 99%

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Testicular Seminoma and Its Mimics:From the Radiologic Pathology Archives

Marko¹,

Wolfman²,

Aubin³

et al. 2017

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Testicular seminoma is the most common malignant tumor of the testis. It classically manifests as a painless mass. Radiologic evaluation with high-frequency ultrasonography (US) is critical for diagnosis. Seminomas are usually homogeneously hypoechoic masses at US. In challenging cases, magnetic resonance (MR) imaging may help confirm that a mass is intratesticular and provide data for local staging. Computed tomography (CT) provides valuable information for staging, including the presence and size of retroperitoneal lymph nodes. Testicular seminoma is treated with radical inguinal orchiectomy and is highly curable even at advanced stages of disease. Several neoplastic and nonneoplastic conditions may mimic testicular seminoma at imaging. Benign mimics include segmental infarction, hematoma, infection, epidermoid cyst, adrenal rests, sarcoidosis, splenogonadal fusion, and sex cord-stromal tumors. Malignant mimics include nonseminomatous germ cell tumors, lymphoma, and metastases. These conditions are individually reviewed with emphasis on features that allow differentiation from seminoma. Spermatocytic tumor, formerly known as spermatocytic seminoma, accounts for only 1% of testicular tumors. It is distinct from classic seminoma, with unique histologic, molecular, and genetic features. It affects an older patient population than classic seminoma and demonstrates indolent clinical behavior. Radiologists serve a key role in diagnosis, staging, and surveillance of patients with seminoma. A thorough knowledge of related clinical, radiologic, and pathologic findings will help the radiologist contribute to high-quality interdisciplinary care of affected patients.

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Section: Sarcoidosismentioning

confidence: 99%

“…Since isolated testicular involvement is rare, the presence of characteristic findings of pulmonary sarcoidosis may help, although mediastinal adenopathy can be seen with both conditions. Epidemiology may also be helpful, as seminoma commonly affects white men while sarcoidosis more frequently affects black men (42).…”

Section: Sex Cord-stromal Tumorsmentioning

confidence: 99%

Testicular Seminoma and Its Mimics:From the Radiologic Pathology Archives

Marko¹,

Wolfman²,

Aubin³

et al. 2017

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“…4 On ultrasound, the hypoechogenicity and 'infiltrative' pattern seen in the present case are recognized features. 5 Opinions differ on the need for histological proof, with reports of limited biopsy and frozen section, radical orchidectomy in unilateral disease and unilateral orchidectomy in bilateral disease. The peak incidence of sarcoidosis and testicular neoplasia coincide at 20-40 years and this is why most patients end up having an orchidectomy.…”

Section: Commentmentioning

confidence: 99%

Scrotal swelling in sarcoidosis

Khan

Richenberg

Fletcher

2004

JRSM

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Ultrasound is central to the investigation of a scrotal mass, determining whether or not the testes are involved and the nature of any lesions. In a patient with evidence of sarcoidosis elsewhere, surgical intervention may be avoidable. CASE HISTORYFor two months an Afro-Caribbean man aged 35 had been aware of painless scrotal swellings, an enlarging submental mass and multiple small cutaneous lumps on his arms and trunk. He also reported weight loss, lethargy and night sweats. On examination he had bilateral hydroceles, cervical lymphadenopathy, a large non-tender submental swelling and numerous firm cutaneous lumps. Laboratory investigations revealed eosinophilia and a raised erythrocyte sedimentation rate but normal testicular tumour markers. On scrotal ultrasound, in addition to the hydroceles there were geographical echo-poor areas within both testes suggesting a diffuse infiltrate (Figure 1). Bilateral symmetrical hilar lymphadenopathy was noted on the chest radiograph while nothing abnormal was seen on CT of the abdomen and pelvis. Serum angiotensin-1-converting enzyme level was raised at 180 IU/L (normal range 12-36) and pulmonary function tests showed a restrictive defect. A fine-needle aspirate from the submental mass and excision biopsies from a lesion on the right arm were consistent with sarcoidosis. Tests for vasculitis, syphilis, Epstein-Barr virus, acid-fast bacilli and fungi were all negative.Neither testicular biopsy nor an orchidectomy was deemed appropriate. The subsequent clinical course was consistent with the diagnosis of sarcoidosis. With steroid therapy the hydroceles disappeared and the ultrasonic features improved (Figure 2). J O U R N A L O F T H E R O Y A L S O C I E T Y O F M E D I C I N EV o l u m e 9 7 O c t

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“…36,37 By sonography, patients with testicular sarcoidosis may present with a single hyperechoic or homogeneous mass, although more commonly they present with multiple bilateral hypoechoic lesions with or without epididymal involvement. [38][39][40][41][42] In this case, the patient had multiple hypoechoic lesions throughout the solitary left testes with microlithiasis. Based on the patient's initial absence of symptomatic systemic manifestations of sarcoidosis, history of cryptorchidism, age, race, presence of microlithiasis, and failure to respond to corticosteroid therapy, malignancy could not be ruled out.…”

Section: Discussionmentioning

confidence: 80%

Testicular Sarcoidosis: Sonographic Findings

Ghazle

Bhatt

2011

Journal of Diagnostic Medical Sonography

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Testicular sarcoidosis is a rare but benign entity. It is often mistaken for testicular neoplasm, leading to orchiectomy. It is, therefore, extremely important to identify and correctly diagnose testicular sarcoidosis on sonography to avoid unnecessary orchiectomy. This case study reports a young patient who had a prior history of unilateral orchiectomy for cryporchidism and presented with testicular lesions on the contralateral testis. He was later found to have skin lesions and chest symptoms that led to a diagnosis of sarcoidosis.

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Sonographic findings in testicular sarcoidosis simulating malignant nodule

Cited by 11 publications

References 14 publications

Testicular Seminoma and Its Mimics:From the Radiologic Pathology Archives

Testicular Seminoma and Its Mimics:From the Radiologic Pathology Archives

Scrotal swelling in sarcoidosis

Testicular Sarcoidosis: Sonographic Findings

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