Central testicular lesion following varicocelectomy

Varicocelectomy is a commonly performed urologic procedure for the surgical correction of abnormal dilation of the venous pampiniform plexus draining the testicle. Of the surgical approaches, laparoscopic surgical correction is a minimally invasive approach, based on the Palomo varicocelectomy, which includes intentional ligation of the testicular artery. While common post-procedure outcomes and potential complications are well documented post-varicocelectomy, this case report and literature review details a man in his 20s who underwent a laparoscopic varicocelectomy and was subsequently found to have a central testicular lesion found on ultrasound to which MRI was performed to rule out a testicular tumour. In exploring this case, we also discuss the literature surrounding artery-sparing vs non-artery-sparing approaches. Although this imaging finding has been seen in other patients within our institution, we highlight this case to exemplify the need to differentiate incidental radiographic findings between benign and non-benign lesions.