Epididymal cyst
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At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresAt the time the article was last revised Jeremy Jones had no financial relationships to ineligible companies to disclose.
View Jeremy Jones's current disclosures- 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:
-
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
-
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 J & Patel A. Sonography of the Abnormal Extratesticular Space. AJR Am J Roentgenol. 1996;167(2):507-11. doi:10.2214/ajr.167.2.8686637 - Pubmed
- 2. Aso C, Enríquez G, Fité M et al. Gray-Scale and Color Doppler Sonography of Scrotal Disorders in Children: An Update. Radiographics. 2005;25(5):1197-214. doi:10.1148/rg.255045109 - Pubmed
- 3. Frauscher F, Klauser A, Stenzl A, Helweg G, Amort B, zur Nedden D. US Findings in the Scrotum of Extreme Mountain Bikers. Radiology. 2001;219(2):427-31. doi:10.1148/radiology.219.2.r01ma42427 - Pubmed
- 4. Dogra V, Gottlieb R, Oka M, Rubens D. Sonography of the Scrotum. Radiology. 2003;227(1):18-36. doi:10.1148/radiol.2271001744 - Pubmed
- 5. Woodward P, Schwab C, Sesterhenn I. From the Archives of the AFIP: Extratesticular Scrotal Masses: Radiologic-Pathologic Correlation. Radiographics. 2003;23(1):215-40. doi:10.1148/rg.231025133 - Pubmed
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- Extratesticular adenomatoid tumour
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- Encysted hydrocele of the spermatic cord
- Chronic appendicitis with coexistent hydrocele and varicocele
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