A 54 year old man, known to have poorly controlled type 2 diabetes mellitus came with a painful scrotal swelling and high grade fever.
Ultrasound examination of the scrotum shows a well defined, heterogeneously hypoechoic lesion in the scrotal wall. It has dense floating echoes representing echogenic debris. The walls of the lesion show an irregular, shaggy appearance. There is severe subcutaneous edema and fat inflammation adjacent to the lesion.