Maitray Patel
SRU Fellow
Mayo Clinic Arizona
Posts: 646
Institution: Mayo Clinic Arizona
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Post by Maitray Patel on Apr 19, 2018 22:52:03 GMT -8
62 yo man presents with rock hard mass in the scrotum, with mild pain.    The images show enlargement and hypoechogenicity of the epididymis with apparent "invasion" of the testis. The epididymis is not particularly hyperemic. This is an "aunt Minnie" in ultrasound, related to BCG epididymitis in patients who have been treated for bladder cancer with intravesicle bcg therapy. The bacilli can spread from the bladder to the epididymis in retrograde fashion and cause a chronic granulomatous epididymitis that is usually quite worrisome on physical examination, being markedly hard. |
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Post by Aya Kamaya on Apr 23, 2018 10:36:47 GMT -8
wow do you want to use this for a case of the day for RSNA?
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Maitray Patel
SRU Fellow
Mayo Clinic Arizona
Posts: 646
Institution: Mayo Clinic Arizona
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Post by Maitray Patel on Apr 23, 2018 10:47:59 GMT -8
I think Nirvi already has.
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Bill Middleton
SRU Fellow
Mallinckrodt Institute of Radiology
Posts: 143
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Post by Bill Middleton on Apr 25, 2018 4:13:36 GMT -8
What a great case!
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Nirvi Dahiya
Executive Board
Mayo Clinic Arizona
Enjoying the SRU Forum - Great Potential for networking
Posts: 37
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Post by Nirvi Dahiya on Apr 25, 2018 7:01:36 GMT -8
62 yo man presents with rock hard mass in the scrotum, with mild pain. The images show enlargement and hypoechogenicity of the epididymis with apparent "invasion" of the testis. The epididymis is not particularly hyperemic. This is an "aunt Minnie" in ultrasound, related to BCG epididymitis in patients who have been treated for bladder cancer with intravesicle bcg therapy. The bacilli can spread from the bladder to the epididymis in retrograde fashion and cause a chronic granulomatous epididymitis that is usually quite worrisome on physical examination, being markedly hard. I have used TB scrotum few years back - no reason why we cannot use it again. This one is a different case. |
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Maitray Patel
SRU Fellow
Mayo Clinic Arizona
Posts: 646
Institution: Mayo Clinic Arizona
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Post by Maitray Patel on Apr 25, 2018 7:14:07 GMT -8
I'm adding 2 articles here for those not familiar with BCG epididymitis. I've now seen about 5 cases. They really do all have a similar "look". |
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Maitray Patel
SRU Fellow
Mayo Clinic Arizona
Posts: 646
Institution: Mayo Clinic Arizona
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Post by Maitray Patel on Jul 24, 2020 15:49:01 GMT -8
This was an example of content in the Interesting and Instructive Cases category. There is more like this available for SRU members--consider joining.
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