Asymptomatic scrotal masses in children.

The ultrasound scans of 16 boys with asymptomatic scrotal masses were retrospectively studied. Ultrasound localized seven of the masses as primary testicular lesions and nine as extratesticular lesions, six of which were hydroceles. Ultrasonography also characterized the scrotal masses as predominantly cystic or solid. Ultrasound could not differentiate benign from malignant disease when a solid mass was found. When a hydrocele was identified, ultrasound was able to image the underlying testis and accurately evaluate it for primary disease. These ultrasound observations can help the surgeon decide when to explore the scrotum and whether to approach the testes via an inguinal or scrotal incision. Conversely, ultrasonographic confirmation of a normal testis may prevent needless surgery and the removal of a normal testis.