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Differential Diagnosis for a Palpable Testicular Mass after Orchitis at the Upper Pole of Testis

  • Single most likely diagnosis
    • Testicular abscess: This is a likely complication of orchitis, where the infection leads to the formation of a collection of pus within the testis, which can be palpable.
  • Other Likely diagnoses
    • Epididymitis: Although the question specifies the mass is at the upper pole of the testis, epididymitis (inflammation of the epididymis) can sometimes present with a palpable mass and is a common condition related to orchitis.
    • Testicular infarction: Following orchitis, reduced blood flow to the testis can lead to infarction, which might present as a palpable mass.
    • Chronic orchitis: This condition can lead to testicular atrophy or the formation of a palpable mass due to chronic inflammation.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Testicular tumor: Although less common than infectious or inflammatory causes, testicular cancer can present as a palpable mass and is critical to diagnose early for effective treatment.
    • Testicular rupture: A severe complication that requires immediate surgical intervention, though it might not always present as a distinct "mass" but rather as acute pain and swelling.
  • Rare diagnoses
    • Spermatocele or epididymal cyst: These are benign cystic structures that can form in the epididymis and might be palpable, though they are less directly related to orchitis.
    • Tuberculous orchitis: In areas where tuberculosis is common, this can be a rare cause of orchitis and subsequent testicular mass.
    • Malacoplakia: A rare inflammatory condition that can affect the testis and present as a mass, though it is exceedingly uncommon.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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