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- Title
Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough?
- Authors
Corvino, Antonio; Catalano, Orlando; Faggian, Guido; Delli Pizzi, Andrea; Tafuri, Domenico; Corvino, Fabio; Borzelli, Antonio; Picchi, Stefano Giusto; Lassandro, Giulia; Boccatonda, Andrea; Schips, Luigi; Cocco, Giulio
- Abstract
Background: Paratesticular tumors (PTs) are very uncommon, accounting for almost 5% of intrascrotal tumors. Of these, adenomatoid tumors (ATs) represent about 30% and most frequently arise in the tail of the epididymis. Ultrasound (US) examination is the first-choice imaging method employed for the evaluation of the scrotum. Unfortunately, there are no specific US-imaging features useful for distinguishing an AT from a malignant lesion. To increase diagnostic accuracy and confidence, new sonographic techniques have incorporated real-time tissue elastography (RTE) under the assumption that malignant lesions are "harder" than benign lesions. Case report: In our paper, we describe a very rare case of a 60-year-old patient with a giant paratesticular mass mimicking malignancy when examined using RTE, i.e., it was stiffer than the surrounding tissue (a hard pattern), which, upon histologic examination, was identified as an AT. Discussion: Our case underscores that there is also a significant overlap between different types of scrotal lesions when RTE is used for examination. Thus, if a PT is found, the imaging approach should always be supplemented with more definitive diagnostic methods, such as FNAC or FNAB, which are the only diagnostic methods capable of leading to a certain diagnosis. Conclusions: Alongside underlining the importance of pre-operative imaging for making correct diagnoses and selecting the correct therapy, we wish to draw our readers' attention to this report in order to demonstrate the clinical implications of a giant AT presenting as stiff lesions when examined using SE.
- Subjects
DIAGNOSTIC ultrasonic imaging; ADENOMATOID tumors; SCROTUM; ELASTOGRAPHY; EPIDIDYMIS
- Publication
Medicina (1010660X), 2023, Vol 59, Issue 7, p1261
- ISSN
1010-660X
- Publication type
Case Study
- DOI
10.3390/medicina59071261