Segmental testicular infarction in a young man simulating a testicular tumor

A 19-year-old boy presented with a 48-hour history of acute onset severe right scrotal pain with minimal scrotal swelling. High-frequency US including color Doppler demonstrated a wedge-shaped, heterogeneous, avascular testicular mass diagnosed preoperatively as a segmental testicular infarction (STI). This was proved at surgery and subsequent histology. The preoperative diagnosis of STI was suggested based on the young man’s presentation of severe pain and the sonographic appearance of the mass. Entertaining the preoperative diagnosis of STI from a testicular tumor is important for testis-sparing surgery even though STI in the pediatric age group is extremely rare.