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Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough?

Background: Paratesticular tumors (PTs) are very uncommon, accounting for almost 5% of intrascrotal tumors. Of these, adenomatoid tumors (ATs) represent about 30% and most frequently arise in the tail of the epididymis. Ultrasound (US) examination is the first-choice imaging method employed for the...

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Autores principales: Corvino, Antonio, Catalano, Orlando, Faggian, Guido, Delli Pizzi, Andrea, Tafuri, Domenico, Corvino, Fabio, Borzelli, Antonio, Picchi, Stefano Giusto, Lassandro, Giulia, Boccatonda, Andrea, Schips, Luigi, Cocco, Giulio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10384894/
https://www.ncbi.nlm.nih.gov/pubmed/37512071
http://dx.doi.org/10.3390/medicina59071261
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author Corvino, Antonio
Catalano, Orlando
Faggian, Guido
Delli Pizzi, Andrea
Tafuri, Domenico
Corvino, Fabio
Borzelli, Antonio
Picchi, Stefano Giusto
Lassandro, Giulia
Boccatonda, Andrea
Schips, Luigi
Cocco, Giulio
author_facet Corvino, Antonio
Catalano, Orlando
Faggian, Guido
Delli Pizzi, Andrea
Tafuri, Domenico
Corvino, Fabio
Borzelli, Antonio
Picchi, Stefano Giusto
Lassandro, Giulia
Boccatonda, Andrea
Schips, Luigi
Cocco, Giulio
author_sort Corvino, Antonio
collection PubMed
description Background: Paratesticular tumors (PTs) are very uncommon, accounting for almost 5% of intrascrotal tumors. Of these, adenomatoid tumors (ATs) represent about 30% and most frequently arise in the tail of the epididymis. Ultrasound (US) examination is the first-choice imaging method employed for the evaluation of the scrotum. Unfortunately, there are no specific US-imaging features useful for distinguishing an AT from a malignant lesion. To increase diagnostic accuracy and confidence, new sonographic techniques have incorporated real-time tissue elastography (RTE) under the assumption that malignant lesions are “harder” than benign lesions. Case report: In our paper, we describe a very rare case of a 60-year-old patient with a giant paratesticular mass mimicking malignancy when examined using RTE, i.e., it was stiffer than the surrounding tissue (a hard pattern), which, upon histologic examination, was identified as an AT. Discussion: Our case underscores that there is also a significant overlap between different types of scrotal lesions when RTE is used for examination. Thus, if a PT is found, the imaging approach should always be supplemented with more definitive diagnostic methods, such as FNAC or FNAB, which are the only diagnostic methods capable of leading to a certain diagnosis. Conclusions: Alongside underlining the importance of pre-operative imaging for making correct diagnoses and selecting the correct therapy, we wish to draw our readers’ attention to this report in order to demonstrate the clinical implications of a giant AT presenting as stiff lesions when examined using SE.
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spelling pubmed-103848942023-07-30 Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough? Corvino, Antonio Catalano, Orlando Faggian, Guido Delli Pizzi, Andrea Tafuri, Domenico Corvino, Fabio Borzelli, Antonio Picchi, Stefano Giusto Lassandro, Giulia Boccatonda, Andrea Schips, Luigi Cocco, Giulio Medicina (Kaunas) Case Report Background: Paratesticular tumors (PTs) are very uncommon, accounting for almost 5% of intrascrotal tumors. Of these, adenomatoid tumors (ATs) represent about 30% and most frequently arise in the tail of the epididymis. Ultrasound (US) examination is the first-choice imaging method employed for the evaluation of the scrotum. Unfortunately, there are no specific US-imaging features useful for distinguishing an AT from a malignant lesion. To increase diagnostic accuracy and confidence, new sonographic techniques have incorporated real-time tissue elastography (RTE) under the assumption that malignant lesions are “harder” than benign lesions. Case report: In our paper, we describe a very rare case of a 60-year-old patient with a giant paratesticular mass mimicking malignancy when examined using RTE, i.e., it was stiffer than the surrounding tissue (a hard pattern), which, upon histologic examination, was identified as an AT. Discussion: Our case underscores that there is also a significant overlap between different types of scrotal lesions when RTE is used for examination. Thus, if a PT is found, the imaging approach should always be supplemented with more definitive diagnostic methods, such as FNAC or FNAB, which are the only diagnostic methods capable of leading to a certain diagnosis. Conclusions: Alongside underlining the importance of pre-operative imaging for making correct diagnoses and selecting the correct therapy, we wish to draw our readers’ attention to this report in order to demonstrate the clinical implications of a giant AT presenting as stiff lesions when examined using SE. MDPI 2023-07-06 /pmc/articles/PMC10384894/ /pubmed/37512071 http://dx.doi.org/10.3390/medicina59071261 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Corvino, Antonio
Catalano, Orlando
Faggian, Guido
Delli Pizzi, Andrea
Tafuri, Domenico
Corvino, Fabio
Borzelli, Antonio
Picchi, Stefano Giusto
Lassandro, Giulia
Boccatonda, Andrea
Schips, Luigi
Cocco, Giulio
Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough?
title Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough?
title_full Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough?
title_fullStr Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough?
title_full_unstemmed Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough?
title_short Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough?
title_sort multiparametric ultrasound diagnostic approach to malignancy-mimicking adenomatoid tumors of the scrotum: is strain elastography enough?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10384894/
https://www.ncbi.nlm.nih.gov/pubmed/37512071
http://dx.doi.org/10.3390/medicina59071261
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