Orchiopexy A Cause of Benign Testicular Lobulation Fatih Kantarci, MD, Ismail Mihmanli, MD, Mehmet Halit Yilmaz, MD, Serap Cetinkaya, MD, Dogan Selcuk, MD, Gunduz Ogut, MD esticular cancer accounts for only 1% of all malignancies in men, and it is more common in black men. 1 Patients with cryptorchidism are 2.5 to 8 times more likely to have testicular cancer. 2 Testicular cancer commonly presents as a painless mass or vague discomfort in the scrotum. It is essential to obtain the patient’s medical history to narrow the possible diagnoses. The principal role of sonog- raphy in the diagnosis of testicular cancer is to help distinguish intratesticular from extratesticular lesions because most extratesticular masses are benign, and intratestic- ular masses are more likely to be malignant. 3,4 Here we report a case of a patient who had previously undergone orchiopexy in which sonographic examination revealed testicular atrophy and lobulation. To our knowledge, this is the first case report that describes orchiopexy as a cause of testicu- lar lobulation. Received August 12, 2003, from the Department of Radiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey. Revision requested August 25, 2003. Revised manuscript accepted for publication September 9, 2003. Address correspondence and reprint requests to Ismail Mihmanli, MD, Department of Radiology, Istanbul University, Cerrahpasa Medical Faculty, 34300 Istanbul, Turkey. E-mail: mihmanli@yahoo.com. Case Report A 30-year-old man sought treatment for infertility after 2 years of normal sexual intercourse. Physical examination revealed bilateral testis in the scrotal sac. The left testis was smaller than the right testis, and it was normal in consistency on palpation. A painless contour abnormali- ty was palpated on the superior aspect of the left testis. The right testis was normal in size, and physical exami- nation of the right side was unremarkable. The patient had undergone orchiopexy for a left undescended testis when he was 9 years old. Sonographic examination of both testes was per- formed with a high-frequency sonography unit (Sonoline Elegra; Siemens Medical Solutions, Issaquah, WA) equipped with a 4- to 7-MHz linear transducer. Sonographic examination confirmed that the left testis was smaller than the right (left, 28 × 11 × 19 mm, 3.1 cm 3 ; right, 42 × 19 × 21 mm, 9.2 cm 3 ). The testis was seen to attach to the anterior border of the scrotal sac. There was a lobulation on its superior aspect (Fig. 1). The left testis © 2003 by the American Institute of Ultrasound in Medicine • J Ultrasound Med 22:1417–1419, 2003 • 0278-4297/03/$3.50 T Case Report