The clinical history and imaging and pathologic findings in 4 patients with bilateral synchronous testicular tumors of dissimilar histologic types were reviewed. All patients had a large scrotal mass on one side and a smaller nodule on the other one. The appearances of each pair of lesions were different enough to suggest that they could possibly be of different histologic types. The most important role of imaging, however, was its capability to guide the surgical approach to these patients: in 1 case, the smallest lesion was recognized as an epidermoid cyst; in 2 others a conservative approach was deemed possible, given the lesions' small volumes and peripheral locations.
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