Case Author(s): J Lahorra MD and Keith Fischer MD , 6/21/95 . Rating: #D2, #Q4

Diagnosis: spermatic cord hematoma

Brief history:

pain in left testicle


testicular scan- flow

View main image(ts) in a separate image viewer

View second image(ts). testicular scan- immediate static images

View third image(us). testicular ultrasound of the left testicle

Full history/Diagnosis is available below

Diagnosis: spermatic cord hematoma

Full history:

28 year old man with left testicular pain for several days. No fevers.


Tc-99m Pertechnetate


The testicular scan demonstrates no hyperperfusion on the flow study. Immediate static images show a photopenic defect in the expected location of the left testicle with a rim of hyperemia. The ultrasound (actually obtained first), demonstrates a large heterogenous mass filling the left hemiscrotum.


The testicular scan was obtained to confirm a possible tumor, which would have been hyperemic on the flow portion of the study (even though US did not show the mass to be highly vascular). The diiferential diagnosis for a photopenic region with a hyperemic rim includes tumor with central necrosis (age of patient supports this), orchitis with abscess, infected hematoma, hydrocele, and late torsion.


Surgery revealed a large, spermatic cord hematoma.

ACR Codes and Keywords:

References and General Discussion of Testicular Scintigraphy (Anatomic field:Genitourinary System, Category:Effect of Trauma)

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Case number: ts001

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