Objectives: To review a group of testicular lesions either clearly benign or that may simulate malignant neoplasia on testicular ultrasound. To describe those clinical and ultrasound findings allowing to make the right differential diagnosis, and proper clinical management.

Methods: We collect a numerous series of cases seen in the Urological Radiology Unit at the University Hospital "Marques de Valdecilla", Santander (Spain), and evaluated by means of a Logiq 500 GE ultrasound. For this study we used linear multifrequency probes (6-11 mHz).

Results: A series of patients with benign testicular lesions are presented. The most characteristic ultrasound findings in the grey scale, color-Doppler and Angio-Doppler are reviewed.

Conclusion: Ultrasound is the diagnostic tests of choice in the study of scrotal pathology. This technique allows easy differentiation of lesions within the testicles from extra testicular ones. Such a simple difference is of vital value because it is demonstrated that most intra testicular masses are malignant, whereas extra testicular lesions are generally benign. However, experience has demonstrated us that orchyectomies resulting in a benign histological process were the few, although significant. We describe various benign testicular lesions with characteristic ultrasound features. These features in association with patient's clinical picture and negative tumor markers allow surgery avoidance in a given patient. Then, it is a question of knowing and identifying these lesions, and differentiating them from malignant neoplasia lesions with the purpose of avoiding unnecessary surgical interventions.

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