Open AccessImaging modalities for an uncommon inguinal scrotal pathology: A case report and literature review
Author(s) -
Koo Hao Chun,
Xeng Inn Fam,
Erica Yee Hing,
Goh Eng Hong
Publication year - 2017
Publication title -
urology annals
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.355
H-Index - 20
eISSN - 0974-7834
pISSN - 0974-7796
DOI - 10.4103/ua.ua_69_17
Subject(s) - medicine , spermatic cord , scrotum , magnetic resonance imaging , radiology , inguinal canal , differential diagnosis , orchiectomy , physical examination , inguinal hernia , biopsy , surgery , soft tissue , hernia , pathology
Inguinal scrotal swelling is a common presentation to surgical clinic with various differential diagnoses. In most circumstances, a good clinical assessment is sufficient to identify the diagnosis. Imaging is necessary when diagnostic difficulty was encountered. The choice of imaging study could affect the management and outcome. A 60-year-old male presented with an enlarging right inguinal scrotal swelling for 5 years. Clinical examination showed a swelling extended from the right inguinal region down to the right scrotum, firm, not reducible, and not separable from the right testis. Differential diagnoses range from the malignant testicular tumor, irreducible inguinal hernia to the soft-tissue tumor. Ultrasonography and computed tomography scan were unable to conclude the origin of the tumor and involvement of the right testis. Inguinal exploration with potential radical orchiectomy was planned and caused much distress to the patient, resulted in delay in surgery. Intraoperatively, the mass was separated from the testis and spermatic cord, and thus, excision biopsy was performed sparing the testis and spermatic cord. Histopathological examination showed cellular angiofibroma. The right choice of imaging modality is important to provide a precise diagnosis and better treatment plan. This could avoid the unnecessary distress to the patient for potential organ lost. A review through the literature showed the ability of magnetic resonance imaging to better delineate the anatomy of inguinal scrotal soft-tissue mass and thus should have been the imaging modality of choice.