EQUINE VETERINARY EDUCATION / AE / MARCH 2015


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TABLE 1: Differential diagnosis of scrotal enlargement in relation to the affected scrotal structure Scrotal structure


Scrotum


Pathological condition


Vaginal tunics/cavity Scrotal oedema Hydrocoele Scrotal laceration Haematocoele


Scrotal contact dermatitis


Neoplasia Pyocoele Periorchitis Inguinal hernia


Rent in the vaginal tunics with herniation of the testis


Neoplasia Orchitis Testicular neoplasia Testicular abscess Testis


Epididymis Epididymitis


Spermatic cord


Torsion of the spermatic cord


Sperm granuloma Thrombosis of the spermatic artery


Epididymal cysts Varicocoele


Testicular haematoma Neoplasia Testicular cysts


Testicular pseudocyst


Ruptured tunica albuginea Neoplasia tunica albuginea


Fig 1: Unilateral scrotal enlargement in a stallion as a result of a seminoma. Scrotal ultrasonography revealed an enlarged right spermatic cord with several dilated vessels in the pampiniform plexus. In addition, a sizeable mass was palpated in the area of iliac lymph nodes indicating metastasis to at least the abdominal cavity.


becomes an integral part of the investigation since early stage metastasis can be evident as enlargements alongside the pampiniforum plexus and vas deferens (Fig 1), while in cases presenting with acute severe discomfort, ultrasonography of the spermatic cord can demonstrate the presence of abdominal contents (e.g. a small intestinal loop) in the inguinal canal and indicate whether vascularisation of the testicle is affected (arterial blood flow or venous return). Ultrasonographic changes in the spermatic cord associated with a testicular tumour indicate a necessity to perform further investigation for spread beginning with a rectal examination to investigate local metastasis into the draining lymph nodes or abdominal cavity. A potentially useful additional ultrasonographic modality when examining an intra- or paratesticular mass is colour Doppler, which, by highlighting vascular patterns, can help to distinguish between


benign and malignant masses (Huang and Sidhu 2012). Last but not least, a needle biopsy of a mass can be performed to yield a histological diagnosis and help determine the most appropriate treatment. Nevertheless, in practice, histological diagnosis is often performed following orchidectomy, especially when the stallion is only unilaterally affected and removal of the affected organ will not signal the end of the breeding career.


Leiomyoma in the reproductive tract of the stallion


Leiomyomas are benign tumours that originate from smooth muscle cells. While there are a number of reports describing uterine leiomyomas in the mare (Muurlink et al. 2008; Heijltjes et al. 2009), it is still an uncommon problem, and there are even fewer reports of leiomyomas in the reproductive tract of


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