The scrotal mass: cause and diagnosis.

The incidences of various diseases responsible for the occurrence of a scrotal mass have been reported. The testicular scan was used infrequently but was 100 percent accurate in differentiating inflammatory masses from torsion. Thirteen patients with inflammatory masses (9.8 percent) were explored because torsion was suspected. Perhaps increased use of testicular scanning, or in children, Doppler flow studies, would reduce the need for exploration. Twenty-seven of the 278 patients (9.7 percent) had asymptomatic masses which were explored to rule out malignant disease, and only four of these patients were found to have malignant disease. Nineteen of the patients had cystic lesions and 2 had inflammatory lesions. If ultrasound had been used in the evaluation of these patients, exploration might not have been necessary. When the diagnosis of the scrotal mass is obvious, there is no need for further evaluation and the clinician should proceed to appropriate therapy. However, when the diagnosis is doubtful, patients would benefit from increased application of the available diagnostic studies.