Testicular and scrotal conditions: Pathology review

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Testicular and scrotal conditions: Pathology review


Male and female reproductive system disorders

Precocious puberty

Delayed puberty

Klinefelter syndrome

Turner syndrome

Androgen insensitivity syndrome

5-alpha-reductase deficiency

Kallmann syndrome

Male reproductive system disorders

Hypospadias and epispadias

Bladder exstrophy


Penile cancer


Benign prostatic hyperplasia

Prostate cancer


Inguinal hernia




Testicular torsion

Testicular cancer

Erectile dysfunction

Male hypoactive sexual desire disorder

Female reproductive system disorders


Ovarian cyst

Premature ovarian failure

Polycystic ovary syndrome

Ovarian torsion

Krukenberg tumor

Sex cord-gonadal stromal tumor

Surface epithelial-stromal tumor

Germ cell ovarian tumor

Uterine fibroid



Endometrial hyperplasia

Endometrial cancer


Cervical cancer

Pelvic inflammatory disease


Female sexual interest and arousal disorder

Orgasmic dysfunction

Genito-pelvic pain and penetration disorder


Fibrocystic breast changes

Intraductal papilloma

Phyllodes tumor

Paget disease of the breast

Breast cancer

Hyperemesis gravidarum

Gestational hypertension

Preeclampsia & eclampsia

Gestational diabetes

Cervical incompetence

Placenta previa

Placenta accreta

Placental abruption



Potter sequence

Intrauterine growth restriction

Preterm labor

Postpartum hemorrhage


Congenital toxoplasmosis

Congenital cytomegalovirus (NORD)

Congenital syphilis

Neonatal conjunctivitis

Neonatal herpes simplex

Congenital rubella syndrome

Neonatal sepsis

Neonatal meningitis


Gestational trophoblastic disease

Ectopic pregnancy

Fetal hydantoin syndrome

Fetal alcohol syndrome

Reproductive system pathology review

Disorders of sex chromosomes: Pathology review

Prostate disorders and cancer: Pathology review

Testicular tumors: Pathology review

Uterine disorders: Pathology review

Ovarian cysts and tumors: Pathology review

Cervical cancer: Pathology review

Vaginal and vulvar disorders: Pathology review

Benign breast conditions: Pathology review

Breast cancer: Pathology review

Complications during pregnancy: Pathology review

Congenital TORCH infections: Pathology review

Disorders of sexual development and sex hormones: Pathology review

Amenorrhea: Pathology Review

Testicular and scrotal conditions: Pathology review

Sexually transmitted infections: Warts and ulcers: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

HIV and AIDS: Pathology review

Penile conditions: Pathology review


Testicular and scrotal conditions: Pathology review

USMLE® Step 1 questions

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USMLE® Step 1 style questions USMLE

of complete

A 31-year-old man comes to his primary care physician after feeling a lump on his right testicle. The patient denies any associated pain. He has no significant past medical history. Vitals are within normal limits. Physical examination reveals a mobile, soft, round mass superior and posterior to the right testis. The nodule transilluminates when a penlight is held behind it. An ultrasound of the mass is performed and demonstrates posterior acoustic enhancement. Which of the following is the most likely anatomic location of this patient’s condition?  


Content Reviewers

Antonella Melani, MD


Antonia Syrnioti, MD

Evan Debevec-McKenney

Cassidy Dermott

Talia Ingram, MSMI, CMI

In the middle of the night, a 16 year old male named Shane is brought to the emergency department by his parents after waking up with severe pain in his right scrotum. Shane does not recall any traumatic events prior to the onset of his symptoms. On physical examination, the scrotum appears swollen; in addition, you notice that the pain is worsened with elevation of the scrotum, and stroking of the right inner thigh does not result in elevation of the right testis.

Later that day, you meet a 28 year old male called Elias, who comes in for a fertility evaluation. Elias and his wife have been trying to conceive for two years without success. Recently, Elias has also noticed an enlargement and a feeling of pressure in his left scrotum. On physical examination, you palpate a mass along the spermatic cord that feels like a “bag of worms”.

Based on the initial presentation, both Shane and Elias seem to have some form of testicular and scrotal condition. Now, for your exams, remember that the testes begin their development in the abdominal cavity, within the peritoneum. During the third trimester of pregnancy, the testes usually begin to descend into the pelvis via the inguinal canal, and ultimately settle in the scrotum. This needs to occur because sperm can't survive at body temperature, and that’s a high yield fact!

Now, as the testes gradually migrate, a peritoneal outpouching called the processus vaginalis forms, and pulls the layers of the anterolateral abdominal wall with it into the developing scrotum. The testes then follow the processus vaginalis into the scrotum. After the testes have descended to the scrotum, the processus vaginalis closes up. Within the scrotum, each testis remains partially covered by an extension of the peritoneum, which forms a serous layer called the tunica vaginalis. The only part that’s not covered by the tunica vaginalis is where the testes are attached to the epididymis and spermatic cord.


The testicles and scrotum are part of the male reproductive system and can be affected by a variety of conditions. Common testicular and scrotal conditions include epididymitis, orchitis, testicular torsion, cryptorchidism, testicular tumor, varicocele, hydrocele, and spermatocele. Epididymitis refers to an inflammation of the epididymis usually caused by a bacterial infection. Orchitis occurs when there is an inflammation of one or both testicles. It is usually caused by mumps infection, but it can also be caused by bacterial infections, such as sexually transmitted infections. Next, there is testicular torsion, which occurs when the spermatic cord that provides blood to the testicle twists, cutting off the blood supply. There is also cryptorchidism, a common male birth defect that occurs when testicles fail to descend from the abdominal cavity into the scrotum, and often get stuck in the inguinal canal. Next come testicular tumors, which include tumors like germ cell type, such as seminoma. There is also varicocele, which is an enlargement of the veins in the scrotum, similar to varicose veins in the legs. Finally, we have hydrocele, which is a fluid-filled sac that develops in the scrotum, and spermatocele, which is a cyst that develops in the epididymis, usually containing dead sperm cells.


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