Nonpalpable Intratesticular Masses Detected Sonographically

PURPOSE: There is controversy concerning the implications of impalpable testicular masses. We examine the sonographic findings and pathology of such tumors. MATERIALS AND METHODS: Between 1985 and 1994, 3,019 scrotal ultrasound studies were performed for various indications and 15 impalpable masses were discovered. RESULTS: Pathological study revealed 5 seminomas, 6 nonseminomas, 2 "burned-out" tumors, 1 lipoma and 1 granuloma. CONCLUSIONS: Impalpable intratesticular masses are likely to be malignant. Any young man with retroperitoneal or visceral masses should undergo scrotal ultrasound. A testicular mass is likely to be the primary cancer but it may be regressed. Persistent scrotal pain may be a presentation of malignancy and should be evaluated with ultrasound.