Epididymal cyst
Last revised by Dr Jeremy Jones ◉ on 20 Sep 2021
Citation, DOI & article data
Citation:
Weerakkody, Y., Jones, J. Epididymal cyst. Reference article, Radiopaedia.org. (accessed on 18 Aug 2022) https://doi.org/10.53347/rID-9856
Permalink:
rID:
9856
Article created:
28 May 2010 by Dr Yuranga Weerakkody ◉
Revisions:
26 times by 12 users - see full revision history
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Sections:
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Synonyms:
- Epididymal head cyst
- Epididymal cysts
Epididymal cysts are the most common epididymal mass.
On this page:
Epidemiology
Epididymal cysts have been reported in ~30% (range 20-40%) of asymptomatic individuals 5.
Pathology
They are usually of lymphatic origin 2. The cysts contain clear serous fluid, lymphocytes, spermatozoa and debris.
Clinical presentation
Often manifests as a palpable mass. Approximately one-third of patients can be asymptomatic. It may be more prevalent in mountain bikers 3.
Radiographic features
They can be solitary or multiple with ~30% having more than one cyst 5.
Ultrasound
- cyst contents in uncomplicated cases are anechoic with no internal echoes
- posterior acoustic enhancement may be seen
- well-defined anechoic lesions
- larger cysts may contain septations
- larger cysts may displace the testis
- this is a differentiating point from hydrocele which envelops the testis
Differential diagnosis
Imaging differential considerations include:
-
spermatocele
- usually has some internal echotexture, but may be indistinguishable from an epididymal cyst
- epididymal cysts may arise throughout the epididymis, while spermatoceles almost always arise in the epididymal head 4
- tunica vaginalis cyst
-
paratesticular abscess
- will tend to show surrounding inflammatory changes
- clinical context is different
- small hydrocele to be differentiated from large epididymal cyst with septations
See also
References
- 1. Black JA, Patel A. Sonography of the abnormal extratesticular space. AJR Am J Roentgenol. 1996;167 (2): 507-11. AJR Am J Roentgenol (citation) - Pubmed citation
- 2. Aso C, Enríquez G, Fité M et-al. Gray-scale and color Doppler sonography of scrotal disorders in children: an update. Radiographics. 25 (5): 1197-214. doi:10.1148/rg.255045109 - Pubmed citation
- 3. Frauscher F, Klauser A, Stenzl A et-al. US findings in the scrotum of extreme mountain bikers. Radiology. 2001;219 (2): 427-31. Radiology (full text) - Pubmed citation
- 4. Dogra VS, Gottlieb RH, Oka M et-al. Sonography of the scrotum. Radiology. 2003;227 (1): 18-36. Radiology (full text) - doi:10.1148/radiol.2271001744 - Pubmed citation
- 5. Woodward PJ, Schwab CM, Sesterhenn IA. From the archives of the AFIP: extratesticular scrotal masses: radiologic-pathologic correlation. Radiographics. 2003;23 (1): 215-40. Radiographics (full text) - doi:10.1148/rg.231025133 - Pubmed citation
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