During the outpatient department visits 3 and 6 months later, abdominal contrast CT was performed, which revealed that the perirenal hematoma and the
hematocele had shrunk, and there were signs of liquification.
Under sonography, an extrauterine gestational sac might look like a complex mass very similar to other, more common pelvic masses, such as hemorrhagic corpus luteum cysts, pelvic
hematoceles, tubo-ovarian abscesses or remains from pelvic inflammatory disease.
A
hematocele caused by acute trauma to the scrotal contents is usually associated with signs of pain.
Value of early operation in blunt testicular contusion with
hematocele. J Urol 1988; 139:746-7.
(18,20)
Hematocele is the most common finding following trauma, which initially appears echogenic becoming hypoechoic as it evolves.
Hydrocele and more complex fluid collections are easily identified such as epididymal cyst,
hematocele, pyocele.
In our patient, the etiology of the
hematocele was unknown, in the absence of predisposing conditions or previous trauma.
CONCLUSION: Tumors occurring in the para-testicular region may be clinically indistinguishable from testicular tumors, and other scrotal swellings like organized
hematocele, thus resulting in initial misdiagnosis.
Intraoperatively, there were signs of significant periorchitis with adhesions of the testicle to the scrotal wall and a
hematocele. A biopsy was sent for frozen section, which confirmed fibrosis and chronic inflammation with no malignancy identified.
The differential diagnosis includes pyocele,
hematocele, epididymal cyst, epididymal cystic lymphangioma, varicocele, and rhabdomyosarcoma.
Other findings include irregular, poorly defined borders, scrotal wall thickening, and
hematocele (Figure 11).
Conditions like old clotted
hematoceles may simulate malignancy clinically and testicular malignancy itself may present as a secondary hydrocele.
