Seminars in Ultrasound, CT and MRI
Volume 28, Issue 4 , Pages 297-306 , August 2007

Sonography of Pediatric Scrotal Swelling

  • Brian D. Coley, MD

      Affiliations

    • Corresponding Author InformationAddress reprint requests to: Brian D. Coley, MD, Chief, Section of Ultrasound, Department of Radiology, Columbus Children’s Hospital, 700 Children’s Drive, Columbus, Ohio, 43205.

References 

  1. Kennedy PT, Elliott JM, Rice PF, et al. Ultrasonography of intratesticular lesions: its role in clinical management. Ulster Med J. 1999;68:54–58
  2. Middleton WD. Scrotal sonography in 1991. Ultrasound Q. 1991;9:61–87
  3. Aso C, Enriquez G, Fite M, et al. Gray-scale and color Doppler sonography of scrotal disorders in children: an update. Radiographics. 2005;25:1197–1214
  4. Dogra V, Gottlieb R, Oka M, et al. Sonography of the scrotum. Radiology. 2003;227:18–36
  5. Hamm B. Differential diagnosis of scrotal masses by ultrasound. Eur Radiol. 1997;7:668–679
  6. Krone KD, Carroll BA. Scrotal ultrasound. Radiol Clin North Am. 1985;23:121–139
  7. Scott RF, Bayless AP, Calder JF, et al. Indications for ultrasound in the evaluation of the pathological scrotum. Br J Urol. 1986;58:178–182
  8. Danrad R, Askhker L, Smith W. Polyorchidism: imaging may denote reproductive potential of accessory testicle. Pediatr Radiol. 2004;34:492
  9. Giyanani V, McCarthy J, Venable D, et al. Ultrasound of polyorchidism: case report and literature review. J Urol. 1987;138:863–864
  10. Coffin CM, Dehner LP. The male reproductive system. In:  Stocker JT,  Dehner LP editor. Pediatric Pathology. Philadelphia, PA: JB Lippincott Co; 1992;p. 905–919
  11. Kogan S, Hadziselimovic F, Howards SS, et al. Pediatric andrology. In:  Gillenwater JY,  Grayhack JT,  Howards SS, et al. editor. Adult and Pediatric Urology. St. Louis, MO: Mosby; 1996;p. 2623–2674
  12. Chung T, Yao W. Sonographic features of polyorchidism. J Clin Ultrasound. 2002;30:106–108
  13. Shah S, Miller B, Geisler E. Polyorchidism discovered as testicular torsion. Urology. 1992;39:543–544
  14. Amodio J, Maybody M, Slowotsky C, et al. Polyorchidism: report of 3 cases and review of the literature. J Ultrasound Med. 2004;23:951–957
  15. Niedzielski J, Paduch D, Raczynski P. Assessment of adolescent varicocele. Pediatr Surg Int. 1997;12:410–413
  16. Zini A, Buckspan M, Beradinucci D, et al. Loss of left testicular volume in men with clinical left varicocele: correlation with grade of varicocele. Arch Androl. 1998;41:37–41
  17. Sayfan J, Siplovich L, Koltun L, et al. Varicocele treatment in pubertal boys prevents testicular growth arrest. J Urol. 1997;157:1456–1457
  18. Paduch D, Niedzielski J. Repair versus observation in adolescent varicocele: a prospective study. J Urol. 1997;158:1128–1132
  19. Lund L, Tang YC, Roebuck D, et al. Testicular catch-up growth after varicocele correction in adolescents. Pediatr Surg Int. 1999;15:234–237
  20. Brosman S. Testicular tumors in prepubertal children. Urology. 1979;13:581–588
  21. Agarwal P, Palmer J. Testicular and paratesticular neoplasms in prepubertal males. J Urol. 2006;176:875–881
  22. Ciftci A, Bingol-Kologlu M, Senocak M, et al. Testicular tumors in children. J Pediatr Surg. 2001;36:1796–1801
  23. Metcalfe P, Farivar-Mohseni H, Farhat W, et al. Pediatric testicular tumors: contemporary incidence and efficacy of testicular preserving surgery. J Urol. 2003;170:2412–2416
  24. Ross J, Rybicki L, Kay R. Clinical behavior and contemporary management algorithm for prepubertal testis tumors: a summary of the prepubertal testis tumor registry. J Urol. 2002;168:1675–1679
  25. Castleberry RP, Cushing B, Perlman E, et al. Germ cell tumors. In:  Pizzo PA,  Poplack DG editor. Principles and Practice of Pediatric Oncology. Philadelphia, PA: Lippincott-Raven Publishers; 1997;p. 921–945
  26. Skoog SJ. Benign and malignant pediatric scrotal masses. Pediatr Clin North Am. 1997;44:1229–1250
  27. Pohl H, Shukla A, Metcalf P, et al. Prepubertal testis tumors: actual prevalence rate of histological types. J Urol. 2004;172:2370–2372
  28. Finkelstein M, Rosenberg H, Snyder H, et al. Ultrasound evaluation of scrotum in pediatrics. Urology. 1986;27:1–9
  29. Grady RW, Ross JH, Kay R. Patterns of metastatic spread in prepubertal yolk sac tumor of the testis. J Urol. 1995;153:1259
  30. Grady R. Current management of prepubertal yolk sac tumor of the testis. Urol Clin North Am. 2000;27:503–508
  31. Wu H, Snyder H. Pediatric urologic oncology: bladder, prostate, testis. Urol Clin North Am. 2004;31:619–627
  32. Coley BD, Siegel MJ. Male genital tract. In:  Siegel MJ editors. Pediatric Sonography. Philadelphia, PA: Lippincott, Williams & Wilkins; 2002;p. 579–624
  33. Grady R, Ross J, Kay R. Epidemiological features of testicular teratoma in a prepubertal population. J Urol. 1997;158:1191–1192
  34. Rushton HG, Belman AB. Testis-sparing surgery for benign lesions of the prepubertal testis. Urol Clin North Am. 1993;20:27–37
  35. Pearse I, Glick RD, Abramson SJ, et al. Testicular-sparing surgery for benign testicular tumors. J Pediatr Surg. 1999;34:1000–1003
  36. Neumann DP, Abrams GS, Hight DW. Testicular epidermoid cysts in prepubertal children: case report and review of the world literature. J Pediatr Surg. 1997;32:1786–1789
  37. Berkmen F, Alagol H. Germinal cell tumors of the testis in cryptorchids. J Exp Clin Cancer Res. 1998;17:409–412
  38. Kay R. Prepubertal testicular tumor registry. Urol Clin North Am. 1993;20:1
  39. Shukla A, Huff D, Canning D, et al. Juvenile granulosa cell tumor of the testis: contemporary clinical management and pathological diagnosis. J Urol. 2004;171:1900–1902
  40. Thomas J, Ross J, Kay R. Stromal testis tumors in children: a report from the prepubertal testis tumor registry. J Urol. 2001;166:2338–2340
  41. Woodard P, Sohaey R, O’Donoghue M, et al. Tumors and tumorlike lesions of the testis: radiologic-pathologic correlation. Radiographics. 2002;22:189–216
  42. Geraghty MJ, Lee FT, Bernsten SA, et al. Sonography of testicular tumors and tumor-like conditions: a radiologic- pathologic correlation. Crit Rev Diagn Imaging. 1998;39:1–63
  43. Frush DP, Sheldon CA. Diagnostic imaging for pediatric scrotal disorders. Radiographics. 1998;18:969–985
  44. Cittadini G, Gauglio C, Pretolesi F, et al. Bilateral epidermoid cysts of the testis: sonographic and MRI findings. J Clin Ultrasound. 2004;32:370–372
  45. Maizlin Z, Belenky A, Baniel J, et al. Epidermoid cyst and teratoma of the testis: sonographic and histologic similarities. J Ultrasound Med. 2005;24:1403–1409
  46. Dogra V, Gottlieb R, Rubens D, et al. Testicular epidermoid cysts: sonographic features with histopathologic correlation. J Clin Ultrasound. 2001;29:192–196
  47. Bennett G, Garcia R. Benign intratesticular dermoid cyst: sonographic findings. AJR Am J Roentgenol. 2002;179:1315–1317
  48. Cho J, Chang J, Park B, et al. Sonographic and MR imaging findings of testicular epidermoid cysts. AJR Am J Roentgenol. 2002;178:743–748
  49. Moore W, Li S, Rifkin M. Juvenile granulosal cell tumor of the testicle. Ultrasound Q. 2003;19:39–41
  50. Ricci Z, Stein M, Koenigsberg M, et al. Unusual sonographic appearance of a Leydig cell tumor of the testis. Pediatr Radiol. 2004;34:177–178
  51. Worthy L, Miller EI, Chinn DH. Evaluation of extratesticular findings in scrotal neoplasms. J Ultrasound Med. 1986;5:261–263
  52. Luker GD, Siegel MJ. Pediatric testicular tumors: evaluation with gray-scale and color Doppler US. Radiology. 1994;191:561–564
  53. Horstman WG, Melson GL, Middleton WD, et al. Testicular tumors: findings with color Doppler US. Radiology. 1992;185:733–737
  54. Avila NA, Premkumar A, Merke DP. Testicular adrenal rest tissue in congenital adrenal hyperplasia: comparison of MR imaging and sonographic findings. AJR Am J Roentgenol. 1999;172:1003–1006
  55. Avila NA, Shawker TS, Jones JV, et al. Testicular adrenal rest tissue in congenital adrenal hyperplasia: serial sonographic and clinical findings. AJR Am J Roentgenol. 1999;172:1235–1238
  56. Dogra V, Nathan J, Bhatt S. Sonographic appearance of testicular adrenal rest tissue in congenital adrenal hyperplasia. J Ultrasound Med. 2004;23:979–981
  57. Askin FB, Land VJ, Sullivan M, et al. Occult testicular leukemia: testicular biopsy at three years continuous complete remission of childhood leukemia: a Southwest Oncology Group study. Cancer. 1981;47:470–475
  58. Zwanger-Mendelson S, Schneck EH, Doshi V. Burkitt lymphoma involving the epididymis and spermatic cord: sonographic and CT findings. AJR Am J Roentgenol. 1989;153:85–86
  59. Golan G, Lebensart PD, Lossos IS. Ultrasound diagnosis and follow-up of testicular monocytic leukemia. J Clin Ultrasound. 1997;25:453–455
  60. Patriquin HB. Leukemic infiltration of the testis. In:  Siegel BA,  Proto AV editor. Pediatric Disease (Fourth series) test and syllabus. Reston, VA: American College of Radiology; 1993;p. 667–688
  61. Luker GD, Siegel MJ. Color Doppler sonography of the scrotum in children. AJR Am J Roentgenol. 1994;163:649–655
  62. Mazzu D, Jeffrey RB, Ralls PW. Lymphoma and leukemia involving the testicles: findings on gray-scale and color Doppler sonography. AJR Am J Roentgenol. 1995;164:645–647
  63. Ishigami K, Yousef-Zahra D, Abu-Yousef M. Enlargement and hypervascularity of both the epididymis and testis do not exclude involvement with lymphoma or leukemia. J Clin Ultrasound. 2004;32:365–369
  64. Koseoglu V, Akata D, Kutluk T, et al. Neuroblastoma with spermatic cord metastasis in a child: sonographic findings. J Clin Ultrasound. 1999;27:287–289
  65. Sung T, Riedlinger W, Diamond D, et al. Solid extratesticular masses in children: radiographic and pathologic correlation. AJR Am J Roentgenol. 2006;186:483–490
  66. Frates MC, Benson CB, DiSalvo DN, et al. Solid extratesticular masses evaluated with sonography: pathologic correlation. Radiology. 1997;204:43–46
  67. Williams H, Abernethy L, Losty P, et al. Meconium periorchitis: a rare cause of a paratesticular mass. Pediatr Radiol. 2004;34:421–423
  68. Varkonyi I, Fliegel C, Rosslein R, et al. Meconium periorchitis: case report and literature review. Eur J Pediatr Surg. 2000;10:404–407
  69. Han K, Mata J, Zaontz MR. Meconium masquerading as a scrotal mass. Br J Urol. 1998;82:765–767
  70. Netto J, Perez L, Kelly D, et al. Splenogonadal fusion diagnosed by Doppler ultrasonography. Sci World J. 2004;4(suppl 1):253–257
  71. Stewart V, Sellars M, Somers S, et al. Splenogonadal fusion: B-mode and color Doppler sonographic appearances. J Ultrasound Med. 2004;23:1087–1090
  72. Cirillo RL, Coley BD, Binkovitz LA, et al. Sonographic findings in splenogonadal fusion. Pediatr Radiol. 1999;29:73–75
  73. Martin L, Share J, Peters C, et al. Hydrocele of the spermatic cord: embryology and sonographic appearance. Pediatr Radiol. 1996;26:528–530
  74. Gooding G, Leonhardt W, Marshall G, et al. Cholesterol crystals in hydroceles: sonographic detection and possible significance. AJR Am J Roentgenol. 1997;169:527–529
  75. Chung SE, Frush DP, Fordham LA. Sonographic appearances of extratesticular fluid and fluid-containing scrotal masses in infants and children: clues to diagnosis. AJR Am J Roentgenol. 1999;173:741–745
  76. Han BK. Uncommon causes of scrotal and inguinal swelling in children: sonographic appearance. J Clin Ultrasound. 1986;14:421–427
  77. Fenton L, McCabe K. Giant unilateral abdominoscrotal hydrocele. Pediatr Radiol. 2002;32:882–884
  78. Robinson P, Hensor E, Lansdown M, et al. Inguinofemoral hernia: accuracy of sonography in patients with indeterminate clinical features. AJR Am J Roentgenol. 2006;187:1168–1178
  79. Korenkov M, Paul A, Troidl H. Color duplex sonography: diagnostic tool in the differentiation of inguinal hernias. J Ultrasound Med. 1999;18:565–568
  80. Chen KC, Chu CC, Chou TY, et al. Ultrasonography for inguinal hernias in boys. J Pediatr Surg. 1998;33:1784–1787
  81. Sudakoff G, Quiroz F, Karcaaltincaba M, et al. Scrotal ultrasonography with emphasis on the extratesticular space: anatomy, embryology, and pathology. Ultrasound Q. 2002;18:255–273
  82. Homayoon K, Suhre C, Steinhardt G. Epididymal cysts in children: natural history. J Urol. 2004;171:1274–1276
  83. Weidman E, Cendron M, Schned A, et al. Scrotal lymphangioma: an uncommon cause for a scrotal mass. J Ultrasound Med. 2002;21:669–672
  84. Loberant N, Chernihovski A, Goldfeld M, et al. Role of Doppler sonography in the diagnosis of cystic lymphangioma of the scrotum. J Clin Ultrasound. 2002;384–387
  85. Lim G, Lim S, Jeong Y, et al. Infantile scrotal pyocele simulating missed testicular torsion on sonography. J Clin Ultrasound. 2002;31:116–118
  86. Friedman SC, Sheynkin YR. Acute scrotal symptoms due to perforated appendix in children: case report and review of literature. Pediatr Emerg Care. 1995;11:181–182
  87. Yasumoto R, Kawano M, Kawanishi H, et al. Left acute scrotum associated with appendicitis. Int J Urol. 1998;5:108–110
  88. Hsieh DS, Jeng SY, Liu YS. Bilateral idiopathic infantile pyoceles: a case report. Chung Hua I Hsueh Tsa Chih. 1998;61:39–43(Taipei)
  89. Ceylan H, Karaca I, Sari I, et al. Simple testicular cyst: a rare cuase of scrotal swelling in infancy. Int J Urol. 2004;11:352–354
  90. Garcia CJ, Zuniga S, Rosenberg H, et al. Simple intratesticular cysts in children: preoperative sonographic diagnosis and histological correlation. Pediatr Radiol. 1999;29:851–855
  91. Honjo O, Uemura S, Murakami I. Simple testicular cyst in infants: a case report and review of the literature. Eur J Pediatr Surg. 2001;11:425–427
  92. Hamm B, Fobbe F, Loy V. Testicular cysts: differentiation with US and clinical findings. Radiology. 1988;168:19–23
  93. Upadhyay V, Holmes M, Kolbe A. Gonadal preservation in a simple testicular cyst. Pediatr Surg Int. 1998;13:445–446

PII: S0887-2171(07)00048-0

doi: 10.1053/j.sult.2007.05.006

Seminars in Ultrasound, CT and MRI
Volume 28, Issue 4 , Pages 297-306 , August 2007