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© 2008 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 27:1195-1202 • 0278-4297

Benign and Malignant Epididymal Masses Evaluated With Scrotal Sonography

Clinical and Pathologic Review of 85 Patients

Wade G. Alleman, MD, Brian Gorman, MB, BCh, Bernard F. King, MD, Dirk R. Larson, MS, John C. Cheville, MD and Ajay Nehra, MD

Departments of Radiology (W.G.A., B.G., B.F.K.) and Urology (A.N.) and Divisions of Nephrology and Hypertension (B.F.K.), Biostatistics (D.R.L.), and Anatomic Pathology (J.C.C.), Mayo Clinic, Rochester, Minnesota USA.

Address correspondence to Brian Gorman, MB, BCh, Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 USA. E-mail: gorman.brian{at}mayo.edu

Objective. The purpose of this study was to determine whether the clinical history and sonographic appearance of solid epididymal masses could aid in distinguishing benign and malignant disease. Methods. We retrospectively reviewed the medical records of all patients who had solid epididymal masses evaluated by scrotal sonography at our institution between 1996 and 2004. We evaluated multiple clinical and sonographic variables, including lesion size, location, echogenicity, color Doppler characteristics, and calcifications. Results. Of the 85 patients included in the study, 25 (29%) underwent surgical intervention, and 5 (6%) had malignant disease. A mass size of greater than 1.5 cm and the presence of color Doppler flow were statistically significant markers for malignancy (P < .05). Combining these 2 variables as a test for malignancy yielded sensitivity of 100%, specificity of 80%, a positive predictive value of 24%, and a negative predictive value of 100%. Conclusions. Most solid epididymal masses (94%) are benign. A size of greater than 1.5 cm and the presence of color Doppler flow may help identify possible malignant masses.

Key Words: epididymis • paratesticular mass • scrotal sonography

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