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Joseph McDaniels
Medical College of Georgia at Augusta University, USA
Posters & Accepted Abstracts: Clin Nephrol Res
Statement of the Problem: Testicular masses in adolescent and young adult males are of significant concern for malignant disease. There is risk to misdiagnosing benign testicular lesions as cancer. Our objective is to present the clinical course and imaging findings of an intratesticular arteriovenous malformation found in an adolescent male patient. Methodology and Theoretical Orientation: A chart-review of an adolescent male was performed and radiological imaging was recorded. The patient was followed at regular intervals after initial diagnosis. Findings: A 16-year-old male with a history of cryptorchidism of the right testis presented with complaints of a painless mass in the superior portion of the right testis. Same-day ultrasound demonstrated a hypoechoic, solid, oval-shaped intratesticular lesion that showed prominent vascularization on Doppler imaging. Punctate calcifications were also observed bilaterally and were more numerous on the right. Tumor markers acquired at the time of presentation were within normal limits. Magnetic resonance imaging with and without contrast demonstrated an enhancing lesion of the posterior superolateral aspect of the right testis that followed the blood pool, consistent with an arteriovenous malformation. Conclusion & Significance: Intratesticular AVMs are exceedingly rare, with only four other cases noted on literature review. Our case presents several unique findings including concurrent testicular microlithiasis and a history of cryptorchidism. It was decided to manage the case conservatively with scrotal ultrasound surveillance every six months Recent publications 1. Skiadas V, Antoniou A, Primetis H, Moulopoulos L, Vlahos L. Intratesticular arteriovenous malformation. Clinical course, ultrasound and MRI findings of an extremely rare lesion on a 7 year follow-up basis. Int Urol Nephrol. 2006;38(1):119-22. 2. Gulsen F, Mihmanli I, Kantarci F, Eren A, Ataus SO. Testicular arteriovenous malformation: gray-scale and color Doppler ultrasonography features. Case Rep Med. 2011;2011:876206 3. Jafarpishefard MS, Momeni M, Baradaran Mahdavi MM, Momeni F, Kamal S. An intratesticular arteriovenous malformation identified incidentally during ultrasound evaluation of scrotal trauma. Adv Biomed Res. 2016 Dec 27;5:202.
Joseph McDaniels is a medical student interested in translational research in urology. He has a passion for improving health outcomes for surgical patients across cultural and socioeconomic backgrounds. His current interests are primarily in identifying and addressing health disparities in patients diagnosed with urological malignancies and in addressing social and mental health after surgery. His ongoing research involves analysis of several outcome parameters after bladder cancer treatment in a largely African-American population as well as research in depression and suicidality of patients diagnosed with bladder and prostate cancer.
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