title: Benign and malignant epididymal masses evaluated with scrotal sonography: clinical and pathologic review of 85 patients.
abstract: OBJECTIVE
  The purpose of this study was to determine whether the clinical history and sonographic appearance of solid epididymal masses could aid in distinguishing benign and malignant disease.
  
  
  METHODS
  We retrospectively reviewed the medical records of all patients who had solid epididymal masses evaluated by scrotal sonography at our institution between 1996 and 2004. We evaluated multiple clinical and sonographic variables, including lesion size, location, echogenicity, color Doppler characteristics, and calcifications.
  
  
  RESULTS
  Of the 85 patients included in the study, 25 (29%) underwent surgical intervention, and 5 (6%) had malignant disease. A mass size of greater than 1.5 cm and the presence of color Doppler flow were statistically significant markers for malignancy (P < .05). Combining these 2 variables as a test for malignancy yielded sensitivity of 100%, specificity of 80%, a positive predictive value of 24%, and a negative predictive value of 100%.
  
  
  CONCLUSIONS
  Most solid epididymal masses (94%) are benign. A size of greater than 1.5 cm and the presence of color Doppler flow may help identify possible malignant masses.
authors.affiliation: Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
authors.forename: Wade G
authors.initials: WG
authors.lastname: Alleman
authors.forename: Brian
authors.initials: B
authors.lastname: Gorman
authors.forename: Bernard F
authors.initials: BF
authors.lastname: King
authors.forename: Dirk R
authors.initials: DR
authors.lastname: Larson
authors.forename: John C
authors.initials: JC
authors.lastname: Cheville
authors.forename: Ajay
authors.initials: A
authors.lastname: Nehra
mesh_terms: D003937:Diagnosis, Differential; D005834:Genital Neoplasms, Male / Q000145:classification / Q000175:diagnosis* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012611:Scrotum / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014463:Ultrasonography