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Table 1 Causes of asymptomatic unilateral scrotal masses in the pediatric age and testicular abnormalities in Beckwith-Wiedemann syndrome

From: Unilateral testicular enlargement in a teenager with Beckwith-Wiedemann syndrome: a case report

Benign conditions
 - hydrocele, hernia, varicocele, spermatocele/epididymal cyst, sebaceous cyst
 - benign idiopathic macro-orchidism
 - supernumerary testis
 - organized post-traumatic hematocele
Testicular and paratesticular neoplasms
 - germ cell tumors (epidermoid cyst, teratoma, germinoma, yalk sac tumor, embryonal carcinoma, mixed germ cell tumor)
 - gonadal stromal tumors (Leydig or Sertoli cell tumors)
 - lipoma, fibroma, leiomyoma, lymphangioma, fibrosarcoma, rhabdomyosarcoma
 - leukemic infiltration, lymphoma, metastasis (nephroblastoma, neuroblastoma)
 - McCune-Albright syndrome
 - epididymo-orchitis (extrapulmonary tuberculosis)
Compensatory hypertrophy (in the absence of the contralateral testicle)
Testicular abnormalities in Beckwith-Wiedemann syndrome
 - cryptorchidism
 - gonadal interstitial-cell hyperplasia
 - gonadoblastoma
 - enlarged testicle
 - hypoplastic testicle
 - agenesis of the testicle
  1. Causes of painless unilateral scrotal masses, originating from testis, epididymis, spermatic cord or scrotal wall [7,8,9,10]. Endocrinopathies like adrenal remnants in congenital adrenal hyperplasia, precocious puberty, Leydig cell hyperplasia due to familial testotoxicosis have not been included, as they generally determine synchronous bilateral testicular enlargement. In addition, the reported testicular variances in BWS [4].