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Case 69 

Case 69
Chapter:
Case 69
Author(s):

Ellen Chung

DOI:
10.1093/med/9780199758968.003.0069
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date: 19 November 2019

17-year-old with testicular mass.

Longitudinal (left) and transverse (right) ultrasound images reveal a well-circumscribed hypoechoic lesion in the right testicle with echogenic margin and internal echoes in a whorled pattern (arrowhead).

Intratesticular lesions are more likely to be malignant than extratesticular lesions, but are more likely benign in a child than in an adult. Scrotal rhabdomyosarcoma may occur in children. The differential diagnosis for intratesticular tumors in young children is different than in adults. In adults and adolescents, the most common malignancies are seminomas, which are rare prior to puberty. In boys, the most common germ cell tumor is the yolk sac tumor. Benign lesions include mature teratoma and epidermoid. Mature teratoma contains fat and calcifications. Epidermoid cyst is distinguished by the whorled or lamellated appearance of the layers of keratin....

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