AB157. SOH21AS133. A case of segmental testicular infarction masquerading as a testicular neoplasm
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AB157. SOH21AS133. A case of segmental testicular infarction masquerading as a testicular neoplasm

Michelle Horan1, Greta Galambosi2, Eamon Leen1, Liza McLornan1, Aoibhinn McDermott1

1Department of Urology, Connolly Hospital Blanchardstown, Dublin, Ireland; 2Histopathology Department, Connolly Hospital Blanchardstown, Dublin, Ireland

Background: Testicular infarction is rarely encountered, with fewer than 70 case reports in the literature. Complete infarction of the testis is mainly associated with testicular torsion. However, segmental testicular infarction is infrequently seen and is idiopathic in up to 70% of cases. Other aetiologies of segmental infarction include trauma, iatrogenic insult and co-morbid hypercoagulable disease states such as sickle cell disease and vasculitis.

Methods: We present this unusual case of segmental testicular infarction in a healthy 45-year-old man to address the diagnostic challenges that affect clinicians in such cases which can be mistaken for other testicular pathologies. This gentleman had a four day history of sudden onset, severe left testicular pain. He reported no preceding testicular trauma, abscess, infective symptoms or relevant past medical or haematological history. Examination yielded a differential diagnosis of an infective process or testicular neoplasm.

Results: Tumour marker analysis was negative and inflammatory markers were elevated. Initial ultrasound was suggestive of a testicular tumour with a 1.8-cm solid hypo-echoic lesion noted in the mid-lower pole of the left testis. Interval imaging one week later following a course of antibiotics reported stable appearances of the previously noted lesion. This patient proceeded to left radical orchiectomy with pathological examination revealing a segmental infarction of the left testis and the presence of a varicocele.

Conclusions: As demonstrated in our case, these testicular infarcts can present diagnostic radiological and clinical challenges and often masquerade as testicular neoplasms. Raising awareness of this uncommon differential can help to more promptly diagnose testicular infarction in patients presenting with acute scrotal pain.

Keywords: Acute scrotal pain; idiopathic; segmental infarction; testicular infarction; testicular neoplasm


Funding: None.


Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-21-ab157
Cite this abstract as: Horan M, Galambosi G, Leen E, McLornan L, McDermott A. SOH21AS133. A case of segmental testicular infarction masquerading as a testicular neoplasm. Mesentery Peritoneum 2021;5:AB157.

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