adenomatoid tumors , although rare , are the most common tumors of the paratesticular tissues , accounting for approximately 30% of all paratesticular tumors . in men , they are located in the epididymis , testicular tunicae , and rarely , the spermatic cord with most arising in or adjacent to the lower or upper pole of the epididymis . although benign in nature but because they are difficult to differentiate from testicular malignancy these men are often subjected to radical orchiectomy . recently , some authors have tried to define the imaging characteristics of these tumors but since these tumors are rare and experience is limited imaging is still not considered as diagnostic . we report a case that was diagnosed on the basis of clinical suspicion , biochemical investigations , fine - needle aspiration cytology findings and radiological tests and thereby high orchiectomy could be avoided . a 52-year - old male presented with complaints of a painless nodule in right scrotal sac for last 2-years that was gradually but very slowly increasing in size . there was no history suggestive of urinary infection , genitor - urinary tuberculosis or epididymo - orchitis . examination revealed a pea - sized firm , well - marginated , smooth swelling present at the lower pole of testis but that could not be separated with epididymis . scrotal ultrasonography revealed a solid mass at the lower pole of right testis that was relatively hyperechoic as compared to the testicular parenchyma [ figure 1 ] . scrotal mri revealed a well - defined lenticular lesion at lower part of right testis . the lesion displayed signals isointense to slightly hypointense on both t1- and t2-weighted images with adjacent hypointense band . fine - needle aspiration from the mass revealed absence of malignant cells . in view of long clinical history , negative tumor markers , findings typical of adenomatoid tumor on sonography and mri , as reported previously , and absence of malignant cells on cytology local excision was performed under local anesthesia through inguinal incision . at exploration scrotal ultrasonography shows a solid mass at the lower pole of righttestis that was relatively hyperechoic as compared to the testicular parenchyma scrotal mri shows a well - defined lenticular lesion at lower part of right testis . the lesion displays signals isointense to slightly hypointense on both t1 and t2-weighted images with adjacent hypointense band most of these tumors have been present for several years and uniformly behave in a benign fashion . cellular atypia and local invasion have been observed occasionally . nonetheless , because of the long history of these tumors and benign nature surgical excision is adequate . a practical problem faced by clinicians is to differentiate this condition preoperatively from the much commoner testicular malignancy so as to avoid high inguinal orchiectomy especially in younger men . because of the adenomatoid tumor does not produce any characteristic pattern on ultrasound that would allow it to be distinguished from malignant testicular tumors because they can be hypo , hyper or even isoechoic as regards the adjacent parenchyma . it provides additional morphological evidence to allow precise localization of the origin of the mass , may also show contrast - enhancement features that enable further confidence of a benign diagnosis , and may allow conservative management . however , in our case we were able to diagnose this condition after thorough evaluation and thereby could conserve the testis .