Tubular ectasia of rete testis

Tubular ectasia of rete testis (rare plural: retia testes ⁸) represents dilated testicular mediastinal tubules. 

Epidemiology

This condition is more common in men over the age of 55 years.

It is often bilateral, is frequently associated with spermatoceles and may occur as result of a vasectomy ².

Clinical presentation

Asymptomatic condition, detected incidentally.

Pathology

This is a benign condition thought to result from the partial or complete obliteration of the efferent ducts ⁷. These spermatozoa-containing cysts communicate with the tubular system into the epididymis. 

Radiographic features

Ultrasound

At sonography, it appears as multiple small cystic or tubular anechoic structures that replace and enlarge the testicular mediastinum. The geographic shape, lack of mass effect, and lack of internal vascularity (Doppler flow) are helpful to distinguish this benign condition from a partially cystic tumor.

MRI

On MR imaging, the cystic dilatation or ectasia of multiple small tubules of the rete testis appears hyperintense on T2-weighted images. After administration of gadolinium contrast, no internal enhancement is seen.​

Treatment and prognosis

It is a benign finding with no known clinical sequelae ³.

Differential diagnosis

• intratesticular varicocele
  • demonstrates flow on color Doppler
• cystadenoma of the rete testis

See also

• tubular ectasia of the epididymis