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Ultrasound with Doppler is the diagnostic reference. A 22-year-old man presented with right reducible inguinal hernia symptoms and left scrotal discomfort. Sonography showed grade IV extra-testicular varicocele extending into intratesticular parenchyma, with power Doppler demonstrating venous flow in dilated intratesticular channels. No testicular atrophy was seen; only a trace hydrocele was noted.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-rare-case-of-intratesticular-varicocele-diagnosed-on-ultrasound-with-power-doppler/432913/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-rare-case-of-intratesticular-varicocele-diagnosed-on-ultrasound-with-power-doppler/432913.png","ImageObject",300,407,{"name":92,"@type":93},"Blue Pony","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What imaging method confirms intratesticular varicocele in this case?","Question",{"text":112,"@type":113},"Ultrasound with power Doppler confirmed venous flow within dilated intratesticular channels, establishing the diagnosis.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What patient symptoms led to evaluation?",{"text":117,"@type":113},"The patient had a right groin swelling diagnosed as a reducible inguinal hernia and also reported left scrotal discomfort for about one month.",{"name":119,"@type":110,"acceptedAnswer":120},"What key findings were seen on ultrasound besides intratesticular varicocele?",{"text":121,"@type":113},"A trace left hydrocele was noted, and no definite testicular atrophic changes were observed.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},432913,1790696032,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},962090760266,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Radiology Ca s e Reports 21 (2026) 1078 – 1080  \nAvailable online [at](at www.sciencedirect.com)[ www.sciencedirect.com](at www.sciencedirect.com)  \njournal [homepage:](homepage: www.elsevier.com/locate/radcr)[ www.elsevier.com/locate/radcr](homepage: www.elsevier.com/locate/radcr)  \n| Case Report\u003Cbr>A rare case of intratesticular varicocele: Diagnosed on ultrasound with power Doppler✩\u003Cbr>Dr. Shahid Hussain, MBBS, FCPS\u003Cbr>Department of Radiology, Timergara Teaching Hospital / Timergara Medical College, Dir Lower, Khyber Pakhtunkhwa, Pakistan |  |  |\n| --- | --- | --- |\n| a r t i c l e i n f o |  | a b s t r a c t |\n| Article history:\u003Cbr>Received 28 September 2025 Revised 19 October 2025 Accepted 27 October 2025 |  | Intratesticular varicocele is a rare entity, often associated with extratesticular varicocele. Ultrasound with Doppler remains the gold standard for diagnosis. We present a 22-year-old male with right inguinal swelling diagnosed as reducible inguinal hernia. He also reported left scrotal discomfort. Ultrasound revealed a grade IV extra-testicular varicocele with extension into intratesticular parenchyma. Power Doppler confirmed venous flow within dilated intratesticular channels. A trace hydrocele was noted without testicular atrophy. Intratesticular varicoceleis an uncommon but important condition. Awareness of this entity is crucial to avoid misdiagnosis. Ultrasound with Doppler remains a reliable diagnostic modality.\u003Cbr>© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington.\u003Cbr>This is an open access article under the CC BY-NC-ND license\u003Cbr>([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)) |\n| Keywords:\u003Cbr>Intratesticular varicocele Scrotal ultrasound\u003Cbr>Power Doppler\u003Cbr>Rare case\u003Cbr>Testicular pathology |  |  |\n\nIntroduction  \nVaricocele is a common cause of scrotal discomfort, usually involving extra-testicular dilated pampiniform plexus veins [1]. Intratesticular varicocele, however, is a rare entity with few cases reported in the literature [2–4] . Recognition of this condition is essential to avoid misdiagnosis, and ultrasound with color or power Doppler is the diagnostic modality of choice [1,3,5] .  \nCase presentation  \nA 22-year-old male was referred by a general surgeon for an ultrasound examination to evaluate a right groin swelling. On standing position, ultrasound revealed herniation ofretroperitoneal/omental fat into the proximal part of the right inguinal canal, with spontaneous reduction on the supine position. A diagnosis of right indirect reducible inguinal hernia was made.  \n✩ Competing Interests: The author declares that there are no conflicts of interest regarding the publication of this case report. The author has not received any financial support, grants, or benefits from any commercial source that could influence the work reported in this manuscript.  \nE-mail address: [786drshahid@gmail.com](786drshahid@gmail.com)  \n[https://doi.org/10.1016/j.radcr.2025.10.082](https://doi.org/10.1016/j.radcr.2025.10.082)  \n1930-0433/© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/))  \nFig. 1 – Longitudinal section Gray-scale ultrasound of left testis shows anechoic cystic and tubular structures (arrows) in testicular parenchyma.  \nHowever, the patient also reported swelling and discomfort in the left hemiscrotum for the past 1 month. Ultrasound of the left testis demonstrated dilated anechoic tubular structures at the posterosuperior aspect of the testis, measuring 3.5-4 mm in diameter, consistent with a grade IV extratesticular varicocele. These tubular structures were noted to extend into and communicate with similar intratesticular anechoic tubular channels (3-4 mm in diameter) within the testicular parenchyma. Power Dop","cbCaiapNJYlV4wwY","https://ap.wps.com/l/cbCaiapNJYlV4wwY","pdf",881929,"English","# Case Report\n## Introduction\n## Case presentation\n## Discussion\n## Conclusion","[{\"question\":\"What imaging method confirms intratesticular varicocele in this case?\",\"answer\":\"Ultrasound with power Doppler confirmed venous flow within dilated intratesticular channels, establishing the diagnosis.\"},{\"question\":\"What patient symptoms led to evaluation?\",\"answer\":\"The patient had a right groin swelling diagnosed as a reducible inguinal hernia and also reported left scrotal discomfort for about one month.\"},{\"question\":\"What key findings were seen on ultrasound besides intratesticular varicocele?\",\"answer\":\"A trace left hydrocele was noted, and no definite testicular atrophic changes were observed.\"}]","A rare case of intratesticular varicocele - Diagnosed on ultrasound with power Doppler | PDF",1790661880]