Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough?

Background: Paratesticular tumors (PTs) are very uncommon, accounting for almost 5% of intrascrotal tumors. Of these, adenomatoid (ATs) represent about 30% and most frequently arise in the tail epididymis. Ultrasound (US) examination is first-choice imaging method employed evaluation scrotum. Unfortunately, there no specific US-imaging features useful distinguishing an AT from a malignant lesion. To increase diagnostic accuracy confidence, new sonographic techniques have incorporated real-time tissue elastography (RTE) under assumption that lesions “harder” than benign lesions. Case report: In our paper, we describe rare case 60-year-old patient with giant paratesticular mass mimicking malignancy when examined using RTE, i.e., it was stiffer surrounding (a hard pattern), which, upon histologic examination, identified as AT. Discussion: Our underscores also significant overlap between different types scrotal RTE used examination. Thus, if PT found, approach should always be supplemented more definitive methods, such FNAC or FNAB, which only methods capable leading to certain diagnosis. Conclusions: Alongside underlining importance pre-operative making correct diagnoses selecting therapy, wish draw readers’ attention this report order demonstrate clinical implications presenting stiff SE.