What is the differential diagnosis of a non-vascular testicular mass?

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Differential Diagnosis for Testicular Mass Non-Vascular

Single Most Likely Diagnosis

  • Epididymitis: This is often the most common cause of a testicular mass that is non-vascular, especially in the context of inflammation or infection. The epididymis, located at the back of the testicle, can become inflamed, leading to swelling and pain.

Other Likely Diagnoses

  • Hydrocele: A condition where fluid accumulates around a testicle, causing swelling. It's a common cause of a non-vascular testicular mass and can be primary (idiopathic) or secondary due to other conditions like injury or infection.
  • Spermatocele: A cystic structure filled with sperm that arises from the head of the epididymis. It's usually benign and can present as a non-vascular mass.
  • Varicocele: Although typically vascular, a varicocele (enlargement of the veins within the scrotum) can sometimes present as a non-vascular mass if the veins are not prominently dilated or if the diagnosis is made in a setting where the varicocele is not fully apparent.

Do Not Miss Diagnoses

  • Testicular Torsion: Although typically presents with acute pain and may have some vascular compromise, early stages or atypical presentations could mimic a non-vascular mass. It's an emergency that requires prompt surgical intervention.
  • Testicular Cancer: While less common, testicular cancer can present as a painless testicular mass. Given its potential for serious outcomes if not treated early, it's crucial not to miss this diagnosis.

Rare Diagnoses

  • Adrenal Rest Tumors: Rare, benign tumors that can occur in the testes, especially in individuals with congenital adrenal hyperplasia. They can present as non-vascular masses.
  • Cystic Dysplasia of the Testis: A rare congenital anomaly where the testis is replaced by multiple cysts, presenting as a non-vascular mass.
  • Testicular Microlithiasis: While not typically presenting as a mass, in rare cases, it could be considered in the differential for a non-vascular testicular abnormality, especially if there are numerous, small calcifications that could be mistaken for a mass on imaging.

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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