Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Insights into Imaging
Published in: Insights into Imaging 1/2021

Open Access 01-12-2021 | Orchitis | Educational Review

Identifying the deceiver: the non-neoplastic mimickers of genital system neoplasms

Authors: Omer Onder, Ali Devrim Karaosmanoglu, Jessica Kraeft, Aycan Uysal, Musturay Karcaaltincaba, Deniz Akata, Mustafa Nasuh Ozmen, Peter F. Hahn

Published in: Insights into Imaging | Issue 1/2021

Login to get access

Abstract

Tumors of the genital system are common and imaging is of crucial importance for their detection and diagnosis. Several non-neoplastic diseases may mimic these tumors and differential diagnosis may be difficult in certain cases. Misdiagnosing non-neoplastic diseases as tumor may prompt unnecessary medical treatment or surgical interventions. In this article, we aimed to present the imaging characteristics of non-neoplastic diseases of the male and female genital systems that may mimic neoplastic processes. Increasing awareness of the imaging specialists to these entities may have a severe positive impact on the management of these patients.
Literature
1.
Kitzing YX, Prando A, Varol C, Karczmar GS, Maclean F, Oto A (2016) Benign conditions that mimic prostate carcinoma: MR imaging features with histopathologic correlation. Radiographics 36(1):162–175PubMedCrossRef
2.
Rosenkrantz AB, Taneja SS (2014) Radiologist, be aware: ten pitfalls that confound the interpretation of multiparametric prostate MRI. AJR Am J Roentgenol 202(1):109–120PubMedCrossRef
3.
Thomas S, Oto A (2018) Multiparametric MR imaging of the prostate: pitfalls in interpretation. Radiol Clin N Am 56(2):277–287PubMedCrossRef
4.
Cheng Y, Huang L, Zhang X, Ji Q, Shen W (2015) Multiparametric magnetic resonance imaging characteristics of prostate tuberculosis. Korean J Radiol 16(4):846–852PubMedPubMedCentralCrossRef
5.
Stillwell TJ, DeRemee RA, McDonald TJ, Weiland LH, Engen DE (1987) Prostatic involvement in Wegener’s granulomatosis. J Urol 138(5):1251–1253PubMedCrossRef
6.
Takeuchi H, Kuroda I, Takizawa I, Aoyagi T, Tachibana M (2016) Granulomatosis with polyangiitis (Wegener’s granulomatosis) accompanied by dysuria. Case Rep Urol 2016:7812875PubMedPubMedCentral
7.
Dufour JF, Le Gallou T, Cordier JF et al (2012) Urogenital manifestations in Wegener granulomatosis: a study of 11 cases and review of the literature. Medicine (Baltimore) 91(2):67–74CrossRef
8.
Huong DL, Papo T, Piette JC et al (1995) Urogenital manifestations of Wegener granulomatosis. Medicine (Baltimore) 74(3):152–161CrossRef
9.
Hart PA, Smyrk TC, Chari ST (2013) IgG4-related prostatitis: a rare cause of steroid-responsive obstructive urinary symptoms. Int J Urol 20(1):132–134PubMedCrossRef
10.
Buijs J, de Buy Wenniger LM, van Leenders G et al (2014) Immunoglobulin G4-related prostatitis: a case-control study focusing on clinical and pathologic characteristics. Urology 83(3):521–527PubMedCrossRef
11.
Hedgire SS, McDermott S, Borczuk D, Elmi A, Saini S, Harisinghani MG (2013) The spectrum of IgG4-related disease in the abdomen and pelvis. Am J Roentgenol 201(1):14–22CrossRef
12.
Coursey Moreno C, Small WC, Camacho JC et al (2015) Testicular tumors: what radiologists need to know–differential diagnosis, staging, and management. Radiographics 35(2):400–415PubMedCrossRef
13.
Marko J, Wolfman DJ, Aubin AL, Sesterhenn IA (2017) Testicular seminoma and its mimics: from the radiologic pathology archives. Radiographics 37(4):1085–1098PubMedCrossRef
14.
Mittal PK, Abdalla AS, Chatterjee A et al (2018) Spectrum of extratesticular and testicular pathologic conditions at scrotal MR imaging. Radiographics 38(3):806–830PubMedCrossRef
15.
16.
Werner CA (1950) Mumps orchitis and testicular atrophy; a factor in male sterility. Ann Intern Med 32(6):1075–1086PubMedCrossRef
17.
Basekim CC, Kizilkaya E, Pekkafali Z, Baykal KV, Karsli AF (2000) Mumps epididymo-orchitis: sonography and color Doppler sonographic findings. Abdom Imaging 25(3):322–325PubMedCrossRef
18.
Watanabe Y, Dohke M, Ohkubo K et al (2000) Scrotal disorders: evaluation of testicular enhancement patterns at dynamic contrast-enhanced subtraction MR imaging. Radiology 217(1):219–227PubMedCrossRef
19.
Michaelides M, Sotiriadis C, Konstantinou D, Pervana S, Tsitouridis I (2010) Tuberculous orchitis US and MRI findings. Correlation with histopathological findings. Hippokratia 14(4):297PubMedPubMedCentral
20.
Muttarak M, Peh WC, Lojanapiwat B, Chaiwun B (2001) Tuberculous epididymitis and epididymo-orchitis: sonographic appearances. Am J Roentgenol 176(6):1459–1466CrossRef
21.
Hamidi M, Nikolaidis P, Miller FH et al (2018) Lesions without borders: scrotal lesions that involve both the intratesticular and extratesticular regions. Am J Roentgenol 210(2):W70–W79CrossRef
22.
Sharma P, Ramteke P, Satapathy A, Ray M (2019) Xanthogranulomatous orchitis presenting as a scrotal mass in an elderly male: malignancy or mimicker? Clin Med Insights Case Rep 12:1179547619890295CrossRefPubMedPubMedCentral
23.
Mannan AASR, Kahvic M, Sara YA, Bharati C (2009) An unusual case of extensive xanthogranulomatous orchitis in a diabetic patient. Med Princ Pract 18(5):418–421CrossRef
24.
Amin Said SH, Abdalla RY, Aghaways I, Abdullah AM (2019) Xanthogranulomatous orchitis: review of the published work, and report of one case. Urol Case Rep 27:100908CrossRef
25.
Val-Bernal JF, González-Márquez P, Ramos-Barseló E, Portillo JA (2010) Concurrent xanthogranulomatous orchiepididymitis and seminoma in the same testis. Pathol Int 60(1):55–58PubMedCrossRef
26.
Dogra VS, Gottlieb RH, Rubens DJ, Liao L (2001) Benign intratesticular cystic lesions: US features. Radiographics 21(suppl_1):S273–S281PubMedCrossRef
27.
Cassidy FH, Ishioka KM, McMahon CJ et al (2010) MR imaging of scrotal tumors and pseudotumors. Radiographics 30(3):665–683PubMedCrossRef
28.
Dixit A, Hague C, Bicknell S (2017) Testicular vasculitis: a sonographic and pathologic diagnosis. Case Rep Radiol 2017:8923621PubMedPubMedCentral
29.
Bosmuller H, von Weyhern CH, Adam P, Alibegovic V, Mikuz G, Fend F (2011) Paratesticular fibrous pseudotumor: an IgG4-related disorder? Virchows Arch 458(1):109–113PubMedCrossRef
30.
Lal J, Bhat S, Doddamani S, Devi L (2016) Isolated testicular immunoglobulin G4-related disease: a mimicker of malignancy. Indian J Urol 32(4):326–328PubMedPubMedCentralCrossRef
31.
Ghazle HH, Bhatt S (2011) Testicular sarcoidosis: sonographic findings. J Diagn Med Sonogr 27(3):126–130CrossRef
32.
Joel J, Thomas J, Gill K, Biyani CS (2014) Testicular sarcoidosis masquerading as testicular carcinoma. Cent Eur J Urol 67(3):261–263CrossRef
33.
Smith AB, Rushing EJ, Smirniotopoulos JG (2010) From the archives of the AFIP: lesions of the pineal region: radiologic-pathologic correlation. Radiographics 30(7):2001–2020PubMedCrossRef
34.
Huang DY, Sidhu PS (2012) Focal testicular lesions: colour Doppler ultrasound, contrast-enhanced ultrasound and tissue elastography as adjuvants to the diagnosis. Br J Radiol 85(Spec No 1):S41–S53PubMedPubMedCentralCrossRef
35.
Bhatt S, Dogra VS (2008) Role of US in testicular and scrotal trauma. Radiographics 28(6):1617–1629PubMedCrossRef
36.
Yusuf G, Konstantatou E, Sellars ME, Huang DY, Sidhu PS (2015) Multiparametric sonography of testicular hematomas: features on grayscale, color doppler, and contrast-enhanced sonography and strain elastography. J Ultrasound Med 34(7):1319–1328PubMedCrossRef
37.
Mohrs OK, Thoms H, Egner T et al (2012) MRI of patients with suspected scrotal or testicular lesions: diagnostic value in daily practice. Am J Roentgenol 199(3):609–615CrossRef
38.
Tsili AC, Bertolotto M, Rocher L et al (2018) Sonographically indeterminate scrotal masses: how MRI helps in characterization. Diagn Interv Radiol 24(4):225PubMedPubMedCentralCrossRef
39.
Fernandez-Perez GC, Tardaguila FM, Velasco M et al (2005) Radiologic findings of segmental testicular infarction. AJR Am J Roentgenol 184(5):1587–1593PubMedCrossRef
40.
Carucci LR, Tirkes AT, Pretorius ES, Genega EM, Weinstein SP (2003) Testicular Leydig’s cell hyperplasia: MR imaging and sonographic findings. AJR Am J Roentgenol 180(2):501–503PubMedCrossRef
41.
Sterbis J, Toritsetimiyin E (2015) Leydig cell hyperplasia in the setting of Klinefelter syndrome. Case Rep 2015:bcr2015209805
42.
Engels M, Span PN, van Herwaarden AE, Sweep FC, Stikkelbroeck NM, Claahsen-van der Grinten HL (2019) Testicular adrenal rest tumors: current insights on prevalence, characteristics, origin, and treatment. Endocr Rev 40(4):973–987PubMedCrossRef
43.
Yılmaz R, Şahin D, Aghayev A et al (2017) Sonography and magnetic resonance imaging characteristics of testicular adrenal rest tumors. Pol J Radiol 82:583PubMedPubMedCentralCrossRef
44.
Sommers D, Winter T (2014) Ultrasonography evaluation of scrotal masses. Radiologic Clinics 52(6):1265–1281PubMed
45.
Kenny D, Batra K, Nancy M, Chhabra A (2008) Tubular ectasia of rete testis with spermatocele. Appl Radiol 37(9):38CrossRef
46.
47.
Wojcik LJ, Hansen K, Diamond DA et al (1997) Cystic dysplasia of the rete testis: a benign congenital lesion associated with ipsilateral urological anomalies. J Urol 158(2):600–604PubMedCrossRef
48.
Poupalou A, Spyridis G, Vakaki M, Giamarelou P, Petousis G, Nikolaidis P (2011) A case of cystic dysplasia of the rete testis in a 17-months-old boy. Case Rep Med 2011
49.
Akbar SA, Sayyed TA, Jafri SZH, Hasteh F, Neill JSA (2003) Multimodality imaging of paratesticular neoplasms and their rare mimics. Radiographics 23(6):1461–1476PubMedCrossRef
50.
Harel M, Makari JH (2014) Paratesticular inflammatory myofibroblastic tumor in a pediatric patient. Case Rep Urol 2014
51.
Caputo A, Califano M, Califano F, D’Antonio A (2019) Inflammatory pseudotumor of the paratesticular region. SN Compr Clin Med 1(11):961–963CrossRef
52.
Bösmüller H, von Weyhern CH, Adam P, Alibegovic V, Mikuz G, Fend F (2011) Paratesticular fibrous pseudotumor—an IgG4-related disorder? Virchows Arch 458(1):109–113PubMedCrossRef
53.
54.
Kho VK-S, Chan P-H (2012) Isolated tuberculous epididymitis presenting as a painless scrotal tumor. J Chin Med Assoc 75(6):292–295PubMedCrossRef
55.
Hassan A, El-Mogy S, Zalata K, Mostafa T (2009) Bilateral testicular tuberculomas: a case detection. Andrologia 41(2):130–135PubMedCrossRef
56.
Savas M, Yeni E, Ciftci H, Cece H, Topal U, Utangac M (2010) Polyorchidism: a three-case report and review of the literature. Andrologia 42(1):57–61PubMedCrossRef
57.
Méndez-Gallart R, Estevez-Martínez E, Rodríguez-Barca P, García-Palacios M, Bautista-Casasnovas A (2012) Incomplete unilateral polyorchidism (bilobed testicle) mimicking testicular tumour. J Pediatr Surg 47(11):2140–2142PubMedCrossRef
58.
Bal K, Ermete M, Balcı U, Dinçel Ç (2014) Splenogonadal fusion: a very rare congenital anomaly in the differential diagnosis of a testicular mass. Turk J Urol 40(1):62PubMedPubMedCentralCrossRef
59.
Revzin MV, Mathur M, Dave HB, Macer ML, Spektor M (2016) Pelvic inflammatory disease: multimodality imaging approach with clinical-pathologic correlation. Radiographics 36(5):1579–1596PubMedCrossRef
60.
Iraha Y, Okada M, Iraha R et al (2017) CT and MR imaging of gynecologic emergencies. Radiographics 37(5):1569–1586PubMedCrossRef
61.
62.
Sah SK, Shi X, Du S et al (2017) CT findings and analysis for misdiagnosis of female pelvic tuberculosis. Radiol Infect Dis 4(1):19–25CrossRef
63.
Pusiol T, Morichetti D, Pedrazzani C, Ricci F (2011) Abdominal-pelvic actinomycosis mimicking malignant neoplasm. Infect Dis Obstet Gynecol 2011:747059PubMedPubMedCentralCrossRef
64.
Lely RJ, van Es HW (2005) Case 85: pelvic actinomycosis in association with an intrauterine device. Radiology 236(2):492–494PubMedCrossRef
65.
Morland D, Hassler S (2015) Case 219: pelvic actinomycosis mimicking malignant tumor. Radiology 276(1):304–308PubMedCrossRef
66.
67.
Bennett GL, Slywotzky CM, Cantera M, Hecht EM (2010) Unusual manifestations and complications of endometriosis–spectrum of imaging findings: pictorial review. AJR Am J Roentgenol 194(6 Suppl):Ws34-46PubMedCrossRef
68.
Foti PV, Farina R, Palmucci S et al (2018) Endometriosis: clinical features, MR imaging findings and pathologic correlation. Insights Imaging 9(2):149–172PubMedPubMedCentralCrossRef
69.
Chamie LP, Blasbalg R, Pereira RM, Warmbrand G, Serafini PC (2011) Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics 31(4):E77-100PubMedCrossRef
70.
Patel MD, Feldstein VA, Chen DC, Lipson SD, Filly RA (1999) Endometriomas: diagnostic performance of US. Radiology 210(3):739–745PubMedCrossRef
71.
Asch E, Levine D (2007) Variations in appearance of endometriomas. J Ultrasound Med 26(8):993–1002PubMedCrossRef
72.
Paik ES, Kim T-J, Choi CH, Kim B-G, Bae D-S, Lee J-W (2018) Clinical outcomes of patients with clear cell and endometrioid ovarian cancer arising from endometriosis. J Gynecol Oncol 29(2):e18PubMedCrossRef
73.
Siegelman ES, Oliver ER (2012) MR imaging of endometriosis: ten imaging pearls. Radiographics 32(6):1675–1691PubMedCrossRef
74.
75.
Chamié LP, Blasbalg R, Pereira RMA, Warmbrand G, Serafini PC (2011) Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics 31(4):E77–E100PubMedCrossRef
76.
77.
Varras M, Tsikini A, Polyzos D, Samara C, Hadjopoulos G, Akrivis C (2004) Uterine adnexal torsion: pathologic and gray-scale ultrasonographic findings. Clin Exp Obstet Gynecol 31(1):34–38PubMed
78.
White M, Stella J (2005) Ovarian torsion: 10-year perspective. Emerg Med Aust EMA 17(3):231–237CrossRef
79.
Oltmann SC, Fischer A, Barber R, Huang R, Hicks B, Garcia N (2009) Cannot exclude torsion: a 15-year review. J Pediatric Surg 44(6):1212–1216 (discussion 7)CrossRef
80.
Tsafrir Z, Azem F, Hasson J et al (2012) Risk factors, symptoms, and treatment of ovarian torsion in children: the twelve-year experience of one center. J Minim Invasive Gynecol 19(1):29–33PubMedCrossRef
81.
Rotoli JM (2017) Abdominal pain in the post-menopausal female: is ovarian torsion in the differential? J Emerg Med 52(5):749–752PubMedCrossRef
82.
Anders JF, Powell EC (2005) Urgency of evaluation and outcome of acute ovarian torsion in pediatric patients. Arch Pediatr Adolesc Med 159(6):532–535PubMedCrossRef
83.
Duigenan S, Oliva E, Lee SI (2012) Ovarian torsion: diagnostic features on CT and MRI with pathologic correlation. Am J Roentgenol 198(2):W122–W131CrossRef
84.
Chang HC, Bhatt S, Dogra VS (2008) Pearls and pitfalls in diagnosis of ovarian torsion. Radiographics 28(5):1355–1368PubMedCrossRef
85.
Ozcan HN, Balci S, Ekinci S et al (2015) Imaging findings of fetal-neonatal ovarian cysts complicated with ovarian torsion and autoamputation. Am J Roentgenol 205(1):185–189CrossRef
86.
Sheth R, Hoelzer D, Scattergood E, Germaine P (2012) In utero fetal ovarian torsion with imaging findings on ultrasound and MRI. Case Rep Radiol 2012
87.
Chukus A, Tirada N, Restrepo R, Reddy NI (2015) Uncommon implantation sites of ectopic pregnancy: thinking beyond the complex adnexal mass. Radiographics 35(3):946–959PubMedCrossRef
88.
O’Neill D, Pounds R, Vella J, Singh K, Yap J (2018) The diagnostic conundrum of chronic ectopic pregnancy: a case report. Case Rep Women’s Health 20:e00086CrossRef
89.
Suzuki H, Chigusa Y, Hamanishi J, Mandai M, Kondoh E (2020) Two cases of ectopic pregnancy mimicking gestational trophoblastic disease. Case Rep Obstetrics Gynecol 2020
90.
Parker RA III, Yano M, Tai AW, Friedman M, Narra VR, Menias CO (2012) MR imaging findings of ectopic pregnancy: a pictorial review. Radiographics 32(5):1445–1460PubMedCrossRef
91.
Hirakawa M, Tajima T, Yoshimitsu K et al (2009) Uterine artery embolization along with the administration of methotrexate for cervical ectopic pregnancy: technical and clinical outcomes. Am J Roentgenol 192(6):1601–1607CrossRef
92.
Cymbaluk-Płoska A, Chudecka-Głaz A, Kuźniak S, Menkiszak J (2016) Ectopic pregnancy treatment by combination therapy. Open Med 11(1):530–536CrossRef
93.
Bromley B, Benacerraf B (1997) Adnexal masses during pregnancy: accuracy of sonographic diagnosis and outcome. J Ultrasound Med 16(7):447–452PubMedCrossRef
94.
Rozalli FI, Rahmat K, Fadzli F, Boylan C, Deb P (2015) Decidualized ovarian endometrioma in a pregnant woman mimicking ovarian malignancy: magnetic resonance imaging and ultrasonographic findings. Iran J Radiol 12(4):e21260
95.
Telischak NA, Yeh BM, Joe BN, Westphalen AC, Poder L, Coakley FV (2008) MRI of adnexal masses in pregnancy. Am J Roentgenol 191(2):364–370CrossRef
96.
Takeuchi M, Matsuzaki K, Nishitani H (2008) Magnetic resonance manifestations of decidualized endometriomas during pregnancy. J Comput Assist Tomogr 32(3):353–355PubMedCrossRef
97.
Wajda K, Lucas J, Marsh W Jr (1989) Hyperreactio luteinalis. Benign disorder masquerading as an ovarian neoplasm. Arch Pathol Lab Med 113(8):921–925PubMed
98.
Tannus JFK, Hertzberg BS, Haystead CM, Paulson EK (2009) Unilateral luteoma of pregnancy mimicking a malignant ovarian mass on magnetic resonance and ultrasound. J Magn Reson Imaging 29(3):713–717PubMedCrossRef
99.
Kohi MP, Rizzuto GA, Fidelman N, Lucero J, Thiet M-P (2015) Retained placenta accreta mimicking choriocarcinoma. Case Rep Pathol 2015
100.
Noonan JB, Coakley FV, Qayyum A, Yeh BM, Wu L, Chen L-M (2003) MR imaging of retained products of conception. Am J Roentgenol 181(2):435–439CrossRef
101.
Sellmyer MA, Desser TS, Maturen KE, Jeffrey RB Jr, Kamaya A (2013) Physiologic, histologic, and imaging features of retained products of conception. Radiographics 33(3):781–796PubMedCrossRef
102.
Kido A, Togashi K, Koyama T et al (2003) Retained products of conception masquerading as acquired arteriovenous malformation. J Comput Assist Tomogr 27(1):88–92PubMedCrossRef
103.
Antonella G, Di Benedetto Luisa AC, Alessandra R, Caserta D (2015) Conservative and timely treatment in retained products of conception: a case report of placenta accreta ritention. Int J Clin Exp Pathol 8(10):13625PubMedCentral
Metadata
Title
Identifying the deceiver: the non-neoplastic mimickers of genital system neoplasms
Authors
Omer Onder
Ali Devrim Karaosmanoglu
Jessica Kraeft
Aycan Uysal
Musturay Karcaaltincaba
Deniz Akata
Mustafa Nasuh Ozmen
Peter F. Hahn
Publication date
01-12-2021
Publisher
Springer International Publishing
Keyword
Orchitis
Published in
Insights into Imaging / Issue 1/2021
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1186/s13244-021-01046-x

Other articles of this Issue 1/2021

Insights into Imaging 1/2021 Go to the issue

Original Article

Shorter anogenital distance is observed in patients with testicular microlithiasis using magnetic resonance imaging

Original Article

Fully automated pelvic bone segmentation in multiparameteric MRI using a 3D convolutional neural network

Original Article

The impact of lung parenchyma attenuation on nodule volumetry in lung cancer screening

Original Article

Appearance of the levator ani muscle subdivisions on 3D transperineal ultrasound

Educational Review

Spinal disorders mimicking infection

Educational Review

Rhino-orbito-cerebral Mucormycosis: Pictorial Review