Differential Diagnosis for Scrotal Ultrasound Findings
Single Most Likely Diagnosis
- Spermatocele: A spermatocele is a benign cystic lesion that typically occurs in the head of the epididymis but can also be found in the tail. It is usually filled with sperm and can appear as a hyperechoic round lesion on ultrasound, which matches the description provided.
Other Likely Diagnoses
- Epididymal Cyst: Similar to a spermatocele, an epididymal cyst is a benign fluid-filled lesion that can occur anywhere along the epididymis, including the tail. It might appear hyperechoic if it contains debris or sperm.
- Adrenal Rest: These are benign lesions that can occur in the testes or along the epididymis, particularly in individuals with congenital adrenal hyperplasia. They can appear hyperechoic on ultrasound.
Do Not Miss Diagnoses
- Testicular Tumor Metastasis to the Epididymis: Although rare, testicular tumors can metastasize to the epididymis. Given the potential severity of testicular cancer, it's crucial not to miss this diagnosis, even if the primary lesion is not visible on the provided ultrasound.
- Epididymal Malignancy: Primary epididymal malignancies are rare but can occur. The presence of a solid, hyperechoic lesion in the epididymis warrants consideration of this diagnosis to ensure timely intervention if necessary.
Rare Diagnoses
- Epididymal Lipoma: A benign tumor composed of fat cells, which could appear hyperechoic on ultrasound due to the echogenic properties of fat.
- Epididymal Hematoma: Although typically associated with trauma, a small, organized hematoma could potentially appear as a hyperechoic lesion in the epididymis.
- Filarial Cyst: In endemic areas, filarial infection can cause cystic lesions in the epididymis, which might appear hyperechoic if filled with debris or sperm.