Intratesticular varicocele.

Varicocele is a common condition, occurring in approximately 15% of males. We present a case of intratesticular varicocele with concomitant extratesticular varicocele. A routine sonographic examination of the left testis revealed multiple hypoechoic, serpiginous, tubular intratesticular structures of various sizes with low-level internal echoes. Duplex Doppler and color flow examination confirmed a low-flow venous pattern with phasic variation that increased during Valsalva's maneuver. These findings were consistent with intratesticular varicocele. Varicocele was also present in the left pampiniform plexus. The main differential considerations in a patient with intratesticular varicocele include cyst, hematoma, epidermoid cyst, and tubular ectasia.