{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:32:00Z","timestamp":1790620320147,"version":"4.1.0"},"reference-count":16,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: Paratesticular tumors (PTs) are very uncommon, accounting for almost 5% of intrascrotal tumors. Of these, adenomatoid tumors (ATs) represent about 30% and most frequently arise in the tail of the epididymis. Ultrasound (US) examination is the first-choice imaging method employed for the evaluation of the scrotum. Unfortunately, there are no specific US-imaging features useful for distinguishing an AT from a malignant lesion. To increase diagnostic accuracy and confidence, new sonographic techniques have incorporated real-time tissue elastography (RTE) under the assumption that malignant lesions are \u201charder\u201d than benign lesions. Case report: In our paper, we describe a very rare case of a 60-year-old patient with a giant paratesticular mass mimicking malignancy when examined using RTE, i.e., it was stiffer than the surrounding tissue (a hard pattern), which, upon histologic examination, was identified as an AT. Discussion: Our case underscores that there is also a significant overlap between different types of scrotal lesions when RTE is used for examination. Thus, if a PT is found, the imaging approach should always be supplemented with more definitive diagnostic methods, such as FNAC or FNAB, which are the only diagnostic methods capable of leading to a certain diagnosis. Conclusions: Alongside underlining the importance of pre-operative imaging for making correct diagnoses and selecting the correct therapy, we wish to draw our readers\u2019 attention to this report in order to demonstrate the clinical implications of a giant AT presenting as stiff lesions when examined using SE.<\/jats:p>","DOI":"10.3390\/medicina59071261","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T01:41:36Z","timestamp":1688694096000},"page":"1261","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough?"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6608-6252","authenticated-orcid":false,"given":"Antonio","family":"Corvino","sequence":"first","affiliation":[{"name":"Movement Sciences and Wellbeing Department, University of Naples \u201cParthenope\u201d, Via Medina 40, I-80133 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orlando","family":"Catalano","sequence":"additional","affiliation":[{"name":"Radiology Unit, Istituto Diagnostico Varelli, I-80126 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Faggian","sequence":"additional","affiliation":[{"name":"Advanced Biomedical Sciences Department, University Federico II of Naples, I-80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Delli Pizzi","sequence":"additional","affiliation":[{"name":"Department of Innovative Technologies in Medicine and Dentistry, University \u201cG. D\u2019Annunzio\u201d, I-6610 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5948-1414","authenticated-orcid":false,"given":"Domenico","family":"Tafuri","sequence":"additional","affiliation":[{"name":"Movement Sciences and Wellbeing Department, University of Naples \u201cParthenope\u201d, Via Medina 40, I-80133 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2593-8148","authenticated-orcid":false,"given":"Fabio","family":"Corvino","sequence":"additional","affiliation":[{"name":"Vascular and Interventional Radiology Department, Cardarelli Hospital, I-80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1730-1139","authenticated-orcid":false,"given":"Antonio","family":"Borzelli","sequence":"additional","affiliation":[{"name":"Vascular and Interventional Radiology Department, Cardarelli Hospital, I-80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano Giusto","family":"Picchi","sequence":"additional","affiliation":[{"name":"Radiology Department, Ospedale del Mare, ASL NA1 Centro, I-80147 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Lassandro","sequence":"additional","affiliation":[{"name":"Radiology Department, Ospedale del Mare, ASL NA1 Centro, I-80147 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Boccatonda","sequence":"additional","affiliation":[{"name":"Internal Medicine, Bentivoglio Hospital, AUSL Bologna, I-40010 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Schips","sequence":"additional","affiliation":[{"name":"Department of Medical, Oral and Biotechnological Sciences, \u201cG. D\u2019Annunzio\u201d University, Urology Unit, SS Annunziata Hospital, I-6610 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3458-5468","authenticated-orcid":false,"given":"Giulio","family":"Cocco","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences, \u201cG. D\u2019Annunzio\u201d University, I-6610 Chieti, Italy"},{"name":"Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, \u201cG. D\u2019Annunzio\u201d University, I-6610 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s40001-018-0301-5","article-title":"Adenomatoid tumor of the testis mimicking malignant testicular cancer on multiparametric ultrasound","volume":"23","author":"Pichler","year":"2018","journal-title":"Eur. J. Med. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1148\/rg.236025174","article-title":"Multimodality imaging of paratesticular neoplasms and their rare mimics","volume":"23","author":"Akbar","year":"2003","journal-title":"Radiographics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s00261-016-0870-0","article-title":"Review of paratesticular pathology: Findings on ultrasound and MRI","volume":"42","author":"Nicola","year":"2017","journal-title":"Abdom. 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