Testicular cancer is uncommon in the general male population, accounting for 1%-2% of all neoplasms and for 5% of urological tumours. It is, however, the most common malignancy in young adult men aged 15-40 years. Although malignancy is prevailing in testicular lesions, and extratesticular masses are most likely benign, in the latter malignancy is encountered in about 3% of cases.
Multiparametric US is the modality of choice for detection and location of scrotal lesions. US identifies lesions in virtually all cases, and is able to distinguish intratesticular from extratesticular lesions. Differential diagnosis, however, is often difficult due to overlap of the imaging findings between tumors, either benign or malignant, and a variety of non-neoplastic lesions.
Compared to US, MRI is more panoramic, and helps characterization due to its capability to differentiate among tissue components. Although in many cases a precise diagnosis is not obtained based on imaging alone, a correct framing of the patient is often possible when epidemiological, clinical, laboratory and imaging findings are considered together.
