Abstract

A-17 year-old boy was admitted to our hospital with the complaints of pain and swelling on his left testis. The scintigraphic view was confirmed by physical examination and was reported as a probable missed torsion.

Case Report

A-17 year-old boy was admitted to our hospital with the complaints of pain and swelling on his left testis. In his history, he had trauma on his left testis five days ago and he went to a doctor. He took non-steroid anti-inflammatory drugs and antibiotics. He was consulted to our clinic because of continuous pain. His laboratory tests were Hb: 15.2 g/dL (12.0-18.0), WBC: 10800 (4.2-10.8). In color Doppler sonography there was no intratesticular flow in his left testis. Following color Doppler sonography, scintigraphy was performed. The scintigraphic view was confirmed by physical examination and was reported as a probable missed torsion. In the surgical operation it was observed that left testis was localized at its normal position, and it was diagnosed that there was just hematoma in the hypoactive region which was detected in the scintigraphy.

Figure 1: Dynamic testicular scintigraphy was performed using 10 mCi of Tc-99m pertechnetate (1 sn/frame, 64x64 matrix, 60 frame).The patient was in supine position. Low energy general collimator was used. In these views a hypoactive region was shown in the superior zone of the left testis (arrow).

Figure 2: Static image (500 count, 256X256 matrix) was recorded 5 minutes after radiotracer injection. The hypoactive appearance of upper-zone localization of left testis was explained with the anamnesis of the patient (post-traumatic fifth day), and it was thought that such appearances were related to missed torsion. During the operation left testis was found to be at its normal anatomical localization. The testis was observed to have its normal color, and it had normal consistency at palpation. An organized hematoma having 3 x 3.5 cm diameter was observed at anterior-superior side of the left testis. Consequently, it was understood that the Doppler sonography measurement was performed on the hematoma, but not on the testis(1,2,3)

Correspondence to

Dr. Duygu Yörük Zonguldak Karaelmas University Department of Nuclear Medicine 67200 Kozlu Zonguldak-TURKEY Phone: +90 372 2610169, ext: 1490 Fax: +90 372 2610155 E-mail: duyguyoruk@dr.com

References