2. Epididymo-orchitis in a 52-year-old man. Color Doppler image shows hypervascularity.
2. Epididymo-orchitis in a 52-year-old man. Axial gadolinium-enhanced fat-saturated T1-weighted image, obtained in another patient, shows an abnormally enhancing and enlarged epididymis with a surrounding rim of fluid (arrow)."
2. Acute epididymitis. Color Doppler image shows increased flow.
3. Diffuse thickening of the spermatic cord in a patient with chronic epididymitis. Longitudinal US image of the left inguinal canal shows a thickened, tortuous spermatic cord (arrows).
2. Clinically proved acute epididymitis in a 16-year-old adolescent boy. The MR imaging examination was performed 6 days after the onset of right scrotal pain. On the coronal dynamic contrast-enhanced subtraction 3D fast field-echo MR images (10.2/4.1; flip angle, 35°) obtained (b) 30 and (c) 360 seconds after injection of contrast medium, the right testis (arrow) shows gradual and progressive increase in homogeneous contrast enhancement similar to that of the left testis. Note that the right epididymis (arrowhead) shows early and intense enhancement. The relative percentages of peak height and mean slope are 99.0% and 91.7%, respectively. Acute epididymitis subsequently was proved to have been caused by sexually transmitted infection with Chlamydia trachomatis.
2. Color Doppler US scan (shown in black and white) reveals increased vascularity in the surrounding parenchyma.
3. Hidradenitis suppurativa. Sonogram of the scrotum shows nonspecific skin thickening (arrow).
4. Scrotal abscess. Axial color Doppler US image in a 30-year-old man with a painful scrotal mass shows a complex, heterogeneous fluid collection with an echogenic and hyperemic wall, findings indicative of an abscess (black arrowheads). Reactive thickening and hyperemia of the parietal vaginal layer (white arrowheads) also are seen.
5. Suspected Fournier gangrene in a 71-year-old man with fever. US image shows echogenic areas (curved arrows) with dirty shadowing representing air in the right scrotal wall and perineum. There is also a localized fluid collection (straight arrow) in the subcutaneous tissue.
2. Right intratesticular abscess in a 46-year-old man with a history of recent right-sided epididymo-orchitis. Axial MR images demonstrate an intratesticular mass (arrow), which had low signal intensity on T1-weighted images (not shown) and has high signal intensity with a hypointense rim on the T2-weighted image.
2. Right intratesticular abscess in a 46-year-old man with a history of recent right-sided epididymo-orchitis. Axial MR images demonstrate an intratesticular mass (arrow), which had low signal intensity on T1-weighted images (not shown). On the axial contrast-enhanced fat-suppressed 3D T1-weighted FSPGR MR image (b), the lesion does not enhance, but there is avid enhancement of surrounding parenchyma.
2. Fournier's Gangrene. Anteroposterior radiograph of the lower pelvis shows subcutaneous emphysema (arrow) in the right hemiscrotum.
2. Tuberculous epididymo-orchitis. Longitudinal US image shows a markedly enlarged epididymal head (arrowhead) with one large and several smaller hypoechoic masses (curved arrows). There are also multiple small hypoechoic lesions within the testis (straight arrows).
2. Hematoxylineosin [H-E] stain) show three typical histopathologic features: granuloma with Langerhans cells (arrow), caseation (middle *), and cystic necrosis (right *).
2. Surgically proved testicular infarction in a 42-year-old man. The MR imaging examination was performed 72 hours after the onset of right scrotal pain. Coronal fat-saturated T2-weighted fast spin-echo MR image (1,800/100) of an upper part of the right testis (arrow) shows low signal intensity.
3. Surgically proved testicular infarction in a 42-year-old man. The MR imaging examination was performed 72 hours after the onset of right scrotal pain. On the coronal dynamic contrast-enhanced subtraction fast spin-echo MR images (514/16) obtained 75 and 345 seconds after injection of contrast medium, the right testis shows heterogeneous contrast enhancement consisting of an upper part (solid arrow) of decreased enhancement and a lower part (open arrow) of normal enhancement, while the left testis shows gradual and progressive increase in homogeneous contrast enhancement.
2. Torsion of Testicular Appendage. Longitudinal US scan of the left hemiscrotum in a patient with scrotal pain and swelling shows a highly echogenic well-defined mass (arrows) at the upper pole of the epididymis (E). The mass represents a twisted epididymal appendage. T = testis."
3. Torsion of Testicular Appendage. Color Doppler image of the same patient shows that the twisted appendage is avascular (arrows). Mild reactive hypervascularity is seen at the epididymal head and scrotal tunics.
4. Testicular torsion in a 13-year-old boy. (a) Longitudinal US scan obtained at the level of the external inguinal ring shows an abrupt change in the configuration of the spermatic cord (arrow), a finding suggestive of torsion at this point.
5. Chronic testicular torsion in a 29-year-old man with 2-3 days of testicular pain. Transverse power Doppler US image also demonstrates absence of perfusion in the testicle itself, with a rim (arrows) of peripheral hyperemia.
2. Surgically proved testicular torsion with hemorrhagic necrosis in a 15-year-old adolescent boy. On the coronal dynamic contrast-enhanced subtraction 3D fast field-echo MR images (10.2/4.1; flip angle, 35°) obtained 90 and 360 seconds after injection of contrast medium, the left testis (solid arrows) shows no contrast enhancement, while the right testis shows gradual and progressive increase in homogeneous contrast enhancement. Note that the left epididymis (arrowhead) is not enhanced at all, and the tunica vaginalis (open arrow) is well enhanced.
2. Color Doppler US scan (shown in black and white) shows flow (arrow) within the tubular structures.
3. Pulse Doppler US scan shows increased flow (arrow) with the Valsalva maneuver, a finding characteristic of venous flow.
2. Color Doppler image shows blood flow signal in both the intestinal loop and the omentum.
2. Testicular rupture. Color Doppler US image depicts an absence of vascularity in the extruded lower pole of the testis (*).
3. Testicular fracture. Longitudinal color Doppler US image in a patient with scrotal trauma depicts a hypoechoic avascular band (arrows) that crosses the testicular parenchyma.
4. Testicular pseudoaneurysm. Color Doppler US image of the right testis in a patient with scrotal trauma demonstrates a focal area with a mosaic of colors (arrow).
5. Gunshot wounds to the testis. Transverse gray-scale US image in a patient with a gunshot wound to the thigh demonstrates multiple echogenic foci (arrowheads) representative of air in the testis.
6. Gunshot wounds to the testis. Longitudinal gray-scale image in another patient with a gunshot wound shows a pellet outside the testis (arrow) with a posterior acoustic shadow (arrowhead).
7. Scrotal electrical burn injury. Sagittal gray-scale image demonstrates a hypoechoic left testis.
8. Scrotal electrical burn injury. Sagittal color Doppler image shows no flow within the left testis, a finding suggestive of infarction. On other color Doppler images (not shown), the right testis had a similar appearance. Image resolution at US was somewhat limited because of burn damage to the skin. At surgery, diffuse parenchymal coagulative necrosis, subcutaneous fat necrosis, and acute inflammation were found.
2. Surgically proved traumatic testicular hemorrhagic necrosis in a 22-year-old man. The MR imaging examination was performed 48 hours after an episode of blunt traumatic scrotal damage. On the coronal dynamic contrast-enhanced subtraction fast spin-echo MR images (514/16) obtained 15 and 345 seconds after injection of contrast medium, the right testis (arrow) shows heterogeneous contrast enhancement consisting of a small central part of minimal enhancement and a large part of no enhancement, while the left testis shows gradual and progressive increase in homogeneous contrast enhancement.
2. Scrotal calculi in a 50-year-old cyclist with scrotal discomfort. Longitudinal US image shows multiple small echogenic cholesterol calculi attached to the parietal layer (arrowheads), with the characteristic comet-tail artifact.
2. Tunica albuginea cyst in an asymptomatic 70-year-old man who had a palpable left testicular mass. Longitudinal US scan shows a well-defined cyst with an imperceptible wall, an anechoic center, and through transmission. A diagnosis of intratesticular cyst was advanced. Findings of tumor markers were negative, but because the mass was palpable, the urologist suspected a malignant tumor. The patient underwent radical orchiectomy, after which a tunica albuginea cyst was confirmed. When large, these cysts can compress the testicular parenchyma, making distinction from an intratesticular cyst difficult, as in this case.
3. Simple intratesticular cyst in a 61-year-old man. A testicular mass was found at an annual physical examination. Findings of tumor markers were negative. Longitudinal US scan of the left testis shows two intratesticular cysts that meet all the US criteria of a simple cyst. Testicular microliths surround the cysts. The case was followed on a yearly basis for 5 years, with no change.
2. Inflammatory masslike lesion of epididymis in inflammatory-associated obstructive azoospermia in 32-year-old man. Longitudinal US image shows an enlarged coarsely hypoechoic masslike lesion (arrowheads) in the caudal portion of the right hemiscrotum.
3. Abnormalities of scrotal vas deferens in 37-year-old man with inflammatory-associated obstructive azoospermia. Bilateral longitudinal US images show dilated scrotal vasa deferentia (arrows). The course of the right scrotal vas deferens is twisted, and echogenic fluid is seen in the lumen. L = left, R = right.
2. Scrotal mesothelioma. Transverse US image shows a hydrocele with several soft-tissue nodules studding the tunica vaginalis (arrows).
3. Fibrous pseudotumor. Longitudinal US image shows a solid mass (arrow) adjacent to the testis (TEST) and epididymis (EPI). The mass is hypoechoic compared with the testis and demonstrates faint posterior shadowing.
4. Adenomatoid tumor. Longitudinal US image shows a well-defined, solid paratesticular mass (arrow). T = testis.
5. Epididymal papillary cystadenoma. US image demonstrates a predominantly solid ovoid mass (M) containing small cystic spaces and located in the head of the epididymis and superior to the testes.
6. Epididymal papillary cystadenoma. US image demonstrates a cystic structure with small papillary projections (arrow).
7. Lymphoma. Transverse US image of the left testis shows an infiltrating, hypoechoic mass (arrow).
8. Lipoma. Longitudinal US image shows a uniformly hypoechoic mass (cursors) superior to the testis (T).
9. Metastatic rhabdomyosarcoma. Longitudinal US image of the inferior portion of the right hemiscrotum shows a lobulated soft-tissue mass involving the tunica vaginalis (long arrows) and testicular capsule (short arrow). T = testis.
10. Metastatic Lymph nodes from Seminoma. Transverse US image shows a heterogeneous mass (black arrow) adjacent to the polycystic left kidney (white arrow). It is difficult to differentiate the mass from the kidney.
11. Histologically proved yolk sac tumor in a 1-year-old boy with a painless unilateral scrotal mass. Longitudinal US scan of the left hemiscrotum shows a solid tumor (T) replacing the entire testis. The cystic areas (arrowheads) represent tumor necrosis.
12. Malignant schwannoma. US image demonstrates a 1.3 × 1-cm heterogeneous mass (arrow) that involves the scrotal wall. The mass is hypoechoic internally and more echogenic peripherally. T = testicticle.
13. Intratesticular lipoma as an incidental finding in a 43-year-old man. (a) Axial sonogram shows a hyperechoic intratesticular lesion (arrow). At color Doppler sonography, no internal flow was seen.
14. Testicular lipomatosis in Cowden disease. The axial color Doppler sonogram shows that innumerable hyperechoic foci are scattered throughout both testes, consistent with fat. No hypervascularity is seen.
15. Burnt-out seminoma in a 24-year-old man. Sagittal sonogram shows an ill-defined, intratesticular calcified lesion (arrow) with posterior acoustic shadowing
16. Leydig cell hyperplasia in a 44-year-old man. US image of the left testicle shows several small, hypoechoic intratesticular lesions (arrows). Similar lesions were noted in the contralateral testis.
17. Bilateral large-cell calcifying Sertoli cell tumor in a 6-year-old boy. Longitudinal US image of the right testis shows multiple echogenic masses with areas of shadowing
18. Metastatic choriocarcinoma. Longitudinal US image shows an isoechoic mass in the inferior pole of the right testis (cursors). It appears to invade the tunica albuginea.
19. Immature teratoma with malignant areas. Transverse US image of the left testis shows a very heterogeneous, ill-defined mass with solid hyperechoic areas and small cysts.
20. Malignant fibrous histiocytoma. (a) US images demonstrate a heterogeneous mass with mixed echogenicity. Because of its large size, the mass was difficult to separate from the testicle. At surgery the testicle proved to be separate from the mass. Marked increased flow was seen at color Doppler US.
21. Metastatic renal cell carcinoma. US image demonstrates a supratesticular solid mass with mixed echogenicity. Color Doppler US demonstrated markedly increased flow within the mass.
2. Hemangioma. Coronal T1-weighted MR image demonstrates a lobulated mass (arrows) that involves the inferior aspect of the hemiscrotum. The lesion has intermediate signal intensity and is confined to the lower scrotum.
3. Intratesticular lipoma as an incidental finding in a 43-year-old man. Axial MR images show an intratesticular lesion (arrow) that is hyperintense on the T1-weighted and T2-weighted images."
4. Sclerosing lipogranuloma. Spin-echo T1-weighted (a), turbo spin-echo T2-weighted (b), and contrast material-enhanced fat-saturated gradient-echo (c) MR images demonstrate diffuse enlargement and heterogeneity of the right epididymis with abnormal enhancement (arrow). There is adjacent scrotal skin thickening. Bilateral hydroceles are also seen.
2. Fibrous pseudotumor. Coronal T2-weighted fat-suppressed image shows a markedly hypointense mass (arrow) with a pedunculated attachment to the tunica. It is surrounded by a high-signal-intensity hydrocele.
3. Lipoma. The mass has high signal intensity on T2-weighted sagittal MR images (arrows).
4. Lipoma. On the coronal T2-weighted, fat-suppressed image, the mass has lower signal intensity (arrow), a finding that confirms the diagnosis of lipoma."
5. Leiomyosarcoma. Sagittal T2-weighted MR image shows a large, solid mass of mixed signal intensity filling the left hemiscrotum (arrow). The testis (not shown) was compressed and displaced medially. B = bladder, arrowhead = prostate."
6. Metastatic Lymph Nodes from Seminoma. Axial gradient echo MR images show anterolateral displacement of the polycystic left kidney by a large retroperitoneal soft-tissue mass.
7. Metastatic Lymph Nodes from Seminoma. Coronal gradient echo MR images show anterolateral displacement of the polycystic left kidney by a large retroperitoneal soft-tissue mass. The mass envelops the aorta and renal arteries, and normal aortic and renal artery flow voids are seen (arrow in b).
8. Adenomatoid tumor. Coronal MR images show the left epididymal tail mass (arrow), which is isointense on T1-weighted images (not shown) and hypointense on the T2-weighted image.
9. Leydig cell tumor and incidental scrotal pearl in a 65-year-old man. Sonogram of the left testis (not shown) demonstrated a nonspecific hypoechoic mass. Coronal MR images show a left intratesticular mass (arrowheads) that is hypointense on the T2-weighted image. An incidental right extratesticular scrotal pearl (arrow) is uniformly hypointense on the T2-weighted image.
10. Sertoli cell tumor. Sonogram (not shown) demonstrated a well-defined hypoechoic nonspecific intratesticular nodule. On axial MR images, the intratesticular nodule (arrow) was barely visible on T1-weighted images (not shown), is hypointense on the T2-weighted image.
11. Nonseminomatous germ cell tumor. Sonogram (not shown) demonstrated a heterogeneously hypoechoic ill-defined left intra-testicular mass with internal flow. Coronal T2-weighted MR image shows an intratesticular mass (arrow) containing cystic and solid components that almost replaces the left testis.
12. Left testicular lymphoma in a 62-year-old man. Axial MR images show an infiltrative intratesticular mass (arrow) enlarging the left testis, which was slightly hypointense to the normal testis on T1-weighted images (not shown), is markedly hypointense on the T2-weighted image. The epididymis (arrowheads) was of heterogeneously lower signal intensity than the contralateral epididymis on the T2-weighted image and was found to be infiltrated by lymphomatous tissue after surgical excision.
13. Hemangioma. Axial fast spin-echo T2-weighted MR image shows that the lesion is separate from the adjacent testicle and epididymis. The hyperintense areas represent stagnant blood. Several small foci of signal void (arrowheads) likely represent thrombus.
14. Leydig cell hyperplasia in a 51-year-old man. Axial sonogram (not shown) demonstrated a well-defined hypoechoic intratesticular nodule. Axial MR images through the right groin show an intra-testicular nodule (arrowhead) that was isointense relative to the right testis on T1-weighted images (not shown), is hypointense on the T2-weighted image, and demonstrates hyperenhancement (relative to the testis) on the contrast-enhanced fat-suppressed 3D T1-weighted FSPGR image. The right testis is undescended and located in the inguinal canal.
15. Intratesticular lipoma as an incidental finding in a 43-year-old man. Axial MR images show an intratesticular lesion (arrow) that is hyperintense on the T1-weighted and T2-weighted images. Chemical shift artifact of the first kind is seen on the T2-weighted image, confirming the presence of fat."
16. Burnt-out seminoma in a 24-year-old man. Sagittal T2-weighted image shows a focal area of low-signal-intensity scarring (arrow) without a visible mass.
17. Sclerosing lipogranuloma. Spin-echo T1-weighted (a), turbo spin-echo T2-weighted (b), and contrast material-enhanced fat-saturated gradient-echo (c) MR images demonstrate diffuse enlargement and heterogeneity of the right epididymis with abnormal enhancement (arrow). There is adjacent scrotal skin thickening. Bilateral hydroceles are also seen.
18. Pleomorphic hyalinizing angiectatic tumor. Coronal short inversion time inversion-recovery T2-weighted and contrast-enhanced fat-saturated gradient-echo MR images demonstrate a heterogeneously enhancing mass (arrows) with several signal voids in the midline that adheres to the right testicle. The signal voids reflect the neovascularity of the tumor owing to its angiectatic nature. Small bilateral hydroceles are also present.
2. Liposarcoma. Coronal gadolinium-enhanced T1-weighted, fat-suppressed image shows loss of signal in the fatty portions and enhancement of the soft-tissue component of the mass. The normal right testis is displaced inferiorly. T = testis.
3. Adenomatoid tumor. On the contrast-enhanced image, the mass has a degree of enhancement similar to that of the normal testis.
4. Spermatic Cord Leiomyosarcoma. Contrast-enhanced fat-suppressed T1-weighted FSPGR MR images show a large infiltrative heterogeneous extratesticular mass (arrows) that demonstrates avid contrast enhancement. An associated loculated hydrocele (arrowhead) is shown.
5. Spermatic Cord Liposarcoma. Coronal contrast-enhanced fat-suppressed 3D T1-weighted FSPGR MR image shows the heterogeneously enhancing mass (arrow) intimately related to the spermatic cord (arrowheads).
6. Leydig cell tumor and incidental scrotal pearl in a 65-year-old man. Sonogram of the left testis (not shown) demonstrated a nonspecific hypoechoic mass. The mass enhances more than the normal testis on the contrast-enhanced image. An incidental right extratesticular scrotal pearl (arrow) with no appreciable enhancement on the contrast-enhanced image.
7. Sertoli cell. Sonogram (not shown) demonstrated a well-defined hypoechoic nonspecific intratesticular nodule. On axial MR images, the intratesticular nodule (arrow) demonstrates homogeneous hyperenhancement (relative to the testis) on the contrast-enhanced image.
8. Nonseminomatous germ cell. Sonogram (not shown) demonstrated a heterogeneously hypoechoic ill-defined left intra-testicular mass with internal flow. Coronal contrast-enhanced MR image shows heterogeneous enhancement of the mass (arrow) after contrast material administration.
9. Left testicular lymphoma in a 62-year-old man. Axial MR images show an infiltrative intratesticular mass (arrow) enlarging the left testis, which was slightly hypointense to the normal testis on T1-weighted images (not shown) and enhances less than the normal testis on the contrast-enhanced image.
10. Leydig cell hyperplasia in a 51-year-old man. Axial sonogram (not shown) demonstrated a well-defined hypoechoic intratesticular nodule. Axial MR images through the right groin show an intra-testicular nodule (arrowhead) that was isointense relative to the right testis on T1-weighted images (not shown), is hypointense on the T2-weighted image, and demonstrates hyperenhancement (relative to the testis) on the contrast-enhanced fat-suppressed 3D T1-weighted FSPGR image. The right testis is undescended and located in the inguinal canal.
11. Epididymal cystadenoma in a 31-year-old patient with a history of von Hippel–Lindau disease who presented with bilateral epididymal masses. Axial gadolinium-enhanced T1-weighted image shows the rim-enhancing mass (arrow) within the epididymis.
12. Sclerosing lipogranuloma. Spin-echo T1-weighted, turbo spin-echo T2-weighted, and contrast material-enhanced fat-saturated gradient-echo MR images demonstrate diffuse enlargement and heterogeneity of the right epididymis with abnormal enhancement (arrow). There is adjacent scrotal skin thickening. Bilateral hydroceles are also seen.
2. Lymphoma. Photograph of the gross specimen of the testis (T), epididymis (E), and spermatic cord (arrows) shows near total replacement of normal parenchyma with a firm, homogeneous, pale yellow, infiltrating tumor.
3. Metastatic rhabdomyosarcoma. Photograph of the bivalved scrotal specimen shows a fleshy, tan tumor (arrows) surrounding the testis. Scale is in centimeters.
4. Liposarcoma. Photograph of the resected tumor shows a lobulated, yellow mass.
5. Seminoma. Photograph of the resected left testis shows the lobular, tan-white mass in the lower pole.
6. Malignant schwannoma. Photograph of the gross specimen of a schwannoma that was removed from a 79-year-old man shows a pink-tan, rubbery, sharply circumscribed tumor. Scale is in centimeters.
7. Bilateral large-cell calcifying Sertoli cell tumor in a 6-year-old boy. Photograph of the gross specimen of the right testis shows multiple well-defined yellowish masses.
8. Immature teratoma with malignant areas. Photograph of the gross specimen shows a glistening, variegated mass with areas of fibrosis and hemorrhage.
9. Malignant fibrous histiocytoma. Photograph of the gross specimen shows a yellow-tan, glistening, bulging tumor that arises in the spermatic cord. The adjacent testicle (arrow) appears compressed. Scale is in centimeters.
2. Papillary cystadenoma in a patient with von Hippel-Lindau disease.Medium-power photomicrograph (original magnification ×70; hematoxylin-eosin stain) shows an ectatic epididymal duct containing a papillary neoplasm lined by clear cells (arrows). The wall of the duct and the adjacent small tubules are also lined by clear cells (arrowheads).
3. Liposarcoma. High-power photomicrograph (original magnification ×120; hematoxylin-eosin stain) shows sclerosis with entrapped lipoblasts (arrow) and multinucleated tumor cells (arrowhead).
4. Seminoma. Photomicrograph shows vague nests of tumor cells separated by a delicate stromal framework. Small numbers of lymphocytes percolate through the tumor. The tumor cell cytoplasm is pale to clear and finely vacuolated, and nuclei are vesicular.
5. Seminoma. Photomicrograph shows a large, irregular, multinucleated cell surrounded by seminoma cells. The specimen contains β-HCG, a finding indicative of an isolated syncytiotrophoblastic cell.
6. Burnt out seminoma. Medium-power photomicrograph (original magnification, ×70; hematoxylin-eosin stain) demonstrates a scar with homogeneous deposits of sparsely cellular collagen. This appearance is consistent with that of a burned-out germ cell tumor.
7. Metastatic choriocarcinoma. High-power photomicrograph (original magnification, ×100; hematoxylin-eosin stain) shows pale-staining cytotrophoblasts (C) surrounded by syncytiotrophoblasts (arrows) along the advancing edge.
8. Fibrous Pseudotumor. Photomicrograph (H-E stain) shows collagen bands in a storiform pattern with small vessels (arrow).
9. Adenematoid. Photomicrograph (H-E stain [inset, ×400; calretinin stain]) shows mesothelial cells (arrows), which characteristically are seen with calretinin stain (inset), and isolated cystic areas (arrowheads).
10. Lymphoma. Photomicrograph (original magnification, ×40; hematoxylin-eosin [H-E] stain) demonstrates sarcomatoid lymphoma cells surrounding a sclerosed and predominantly effaced seminiferous tubule (∗). The lymphoma cells are spindled or twisted, with an irregular nuclear contour (arrow).
11. Lymphoma. Photomicrograph (original magnification, ×10; H-E stain) demonstrates the interface between the uninvolved testis (top) and the portion of the testis involved by lymphoma (bottom).
12. Lymphoma. Photomicrograph (original magnification, ×40; H-E stain) shows diffuse large cells, most of which have large vesicular nuclei with nucleoli that tend to cling to the nuclear envelope (arrow). A few larger, more anaplastic forms with lobate nuclei are also present.
2. Diffuse large B-cell lymphoma with right testicular involvement. Axial fused PET/CT images acquired before chemotherapy.
3. Metastatic rhabdomyosarcoma. Contrast-enhanced axial CT images show a large, heterogeneously enhancing, right scrotal mass (arrow).
4. Residual teratoma after treatment in a patient who presented with a metastatic mixed germ cell tumor. Axial CT image obtained after chemotherapy shows a large, low-attenuation retroperitoneal mass (arrow) causing hydronephrosis of the right kidney. The mass was resected and showed predominantly mature teratoma with foci of immature elements. No malignant cells were identified.
5. Metastatic choriocarcinoma. Chest CT scan (lung windows) shows multiple pulmonary nodules. Gynecomastia is also noted.
6. Metastatic choriocarcinoma. Unenhanced brain CT scan shows a hemorrhagic metastasis with surrounding edema (arrow).
7. Lipoma of the spermatic cord. CT scan demonstrates the mass (M) with fat attenuation in the left inguinal canal."