Differential Diagnosis for Heterogenous Testicle
- Single most likely diagnosis
- Testicular cancer: This is the most likely diagnosis due to the heterogenous appearance of the testicle, which can be indicative of a tumor. Testicular cancer often presents with a palpable mass or testicular asymmetry.
- Other Likely diagnoses
- Epididymitis: Inflammation of the epididymis can cause heterogeneity in the testicle due to swelling and fluid accumulation. This condition is often accompanied by pain and tenderness.
- Hydrocele: A hydrocele is a collection of fluid around the testicle, which can cause the testicle to appear heterogenous on imaging. This condition can be primary (idiopathic) or secondary to trauma, infection, or tumor.
- Spermatocele: A spermatocele is a cystic structure filled with sperm, which can cause heterogeneity in the testicle. This condition is often asymptomatic and discovered incidentally.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Testicular torsion: Although less likely, testicular torsion is a medical emergency that requires prompt attention. It can cause heterogeneity in the testicle due to ischemia and edema. Delayed diagnosis can result in loss of the testicle.
- Metastatic disease: Metastasis to the testicle from other primary cancers (e.g., prostate, lung, or gastrointestinal) can cause heterogeneity. Although rare, this diagnosis should not be missed due to its significant implications for patient management and prognosis.
- Rare diagnoses
- Adrenal rest tumors: These are rare, benign tumors that can occur in the testicle, often in association with congenital adrenal hyperplasia. They can cause heterogeneity in the testicle.
- Polyorchidism: A rare congenital anomaly where there is more than one testicle on one side, which can cause heterogeneity in the testicle.