An unusual scrotal mass: tubular ductal ectasia within the head of the epididymis

A patient complained of a right-sided testicular lump, increasing in size over a month, with some associated mild discomfort. There was no history of trauma or infection. The patient had undergone vasectomy 10 years previously. Clinically, the lump was palpable and it was difficult to determine whether it was intra- or extra-testicular. Ultrasound examination revealed a moderate right-sided hydrocele. The palpable mass was a markedly expanded epididymal head with an unusual echo-pattern, consisting of numerous tubular cystic spaces consistent with ductal ectasia.