A-425 Scrotal tumours

P.S. Sidhu | Sunday, March 10, 14:00 – 15:30 / Room C

Ultrasound remains the imaging modality of choice for the assessment of any form of scrotal pathology. The resolution capabilities of the technique and the superficial nature of the scrotal contents allow ultrasound examination to deliver optimal imaging. Testicular tumours maybe imaged and characterised with ease, without need for further imaging techniques. The addition of colour Doppler ultrasound allows for the interrogation of the vascularity of any lesion seen, and the addition of newer techniques such as contrast-enhanced ultrasound and tissue elastography has beneficial effects to aid interpretation and diagnosis. Nearly all focal abnormalities of the testis in the adult patient are malignant lesions, with primary germ cell tumours a frequent abnormality in the younger patient, and lymphoma or a secondary malignancy common in the older patient. However, benign abnormalities such as a focal infarction, haematoma or an epidermoid cyst may mimic malignancy. It is important to be able differentiate benign from malignant causes, with testis sparing the ultimate goal. Non-germ cell tumours present a specific conundrum, with the newer imaging techniques likely to be of benefit in distinguishing these tumours from germ cell tumours. Extra-testicular tumours are nearly always benign and include lipoma and adenomatoid lesions. Inflammatory disease may also simulate a tumour and presents an unexpected pitfall. A carful scrotal ultrasound examination, using all the available ultrasound techniques should allow the examiner to make a confident assessment of any scrotal tumour, and allow for the correct management without need for further imaging.

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