What is the most common scrotal mass?

What is the most common scrotal mass?

• A. Varicocele
• B. Hydrocele
• C. Seminoma
• D. Epididymal cyst

Answer: (C)

When evaluating a scrotal mass on ultrasound, distinguishing intratesticular from extratesticular lesions is essential. Among intratesticular masses, the most common malignant tumor in adults is seminoma. It typically appears as a solid, hypoechoic intratesticular mass with relatively homogeneous texture and well-defined margins, often showing increased blood flow on Doppler. This classic appearance, in the right age group (young to middle-aged adults), makes seminoma the leading consideration for a new solid testicular mass. In contrast, hydrocele and epididymal cyst are fluid-filled structures around the testis or in the epididymis, and varicocele is a venous dilation of the pampiniform plexus. These are extratesticular or non-solid, and their typical ultrasound patterns differ markedly from a solid intratesticular tumor.

When evaluating a scrotal mass on ultrasound, distinguishing intratesticular from extratesticular lesions is essential. Among intratesticular masses, the most common malignant tumor in adults is seminoma. It typically appears as a solid, hypoechoic intratesticular mass with relatively homogeneous texture and well-defined margins, often showing increased blood flow on Doppler. This classic appearance, in the right age group (young to middle-aged adults), makes seminoma the leading consideration for a new solid testicular mass.

In contrast, hydrocele and epididymal cyst are fluid-filled structures around the testis or in the epididymis, and varicocele is a venous dilation of the pampiniform plexus. These are extratesticular or non-solid, and their typical ultrasound patterns differ markedly from a solid intratesticular tumor.