年輕男性,主訴慢性陰囊疼痛
超音波:
extratesticular hypoechoic tumor in the epididymis showing well-defined contour.
Extratesticular lesion,想的鑑別診斷有epididymal cyst or spermatocele, adenomatoid tumor, leiolyoma, papillary cystadenoma
- epididymal cyst / spermatocele: anechoic + no vascular flow,最常見於epididymal head。常以摸得到的陰囊腫來作表現
- adenomatoid tumor,最常見睪丸外良性腫瘤,US影像有各種表現,多echogenic; 常見於epididymal tail, 但也可以出現在tunica albuginea, 或是沿著spermatic cord長。
- leiomyoma: 第二常見,US多以solid component, hypoechoic tumor 為主,可能出現cystic change or calcification.
- Papillary cystadenoma。直接聯想von Hippel-Lindau disease。cystic lesion with fine septation, 雙側
最後診斷:adenomatoid tumor