Tunica albuginea cyst
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Tunica albuginea (TA) cysts are the most common extratesticular benign scrotal mass lesion. They are a type of scrotal tunica cyst.
The mean age at presentation of tunica albuginea cysts is 40 years (although they may be seen in the 5th and 6th decades).
Tunica albuginea cysts are usually palpable.
They arise from the tunica albuginea, a fibrous layer below the tunica vaginalis which closely covers the testis. The exact pathogenesis of tunica albuginea cysts is not known but they are believed to arise from the mesothelia.
Tunica albuginea cysts are characteristically located at the upper anterior or lateral aspect of the testis.
Ultrasound is the first line modality for imaging of tunica albuginea cysts.
- typically seen as an anechoic paratesticular cyst
- usually ~2-5 mm in diameter
- sharply demarcated
- unilocular or multilocular
- no solid components
- no disturbance of the adjacent testicular tissue
- rarely calcify
- occasional milk of calcium or even a complex appearance
On ultrasound consider:
- 1. Alvarez DM, Bhatt S, Dogra VS. Sonographic spectrum of tunica albuginea cyst. J Clin Imaging Sci. 2011;1 (1): 5. doi:10.4103/2156-7514.73503 - Free text at pubmed - Pubmed citation
- 2. Dogra VS, Gottlieb RH, Rubens DJ et-al. Benign intratesticular cystic lesions: US features. Radiographics. 2001;21 Spec No (suppl_1): S273-81. doi:10.1148/radiographics.21.suppl_1.g01oc15s273 - Pubmed citation
- 3. Martínez-Berganza MT, Sarría L, Cozcolluela R et-al. Cysts of the tunica albuginea: sonographic appearance. AJR Am J Roentgenol. 1998;170 (1): 183-5. doi:10.2214/ajr.170.1.9423628 - Pubmed citation
- 4. Gittleman AM, Perlmutter S, Hutchinson A et-al. Milk of calcium in a tunica albuginea cyst. J Ultrasound Med. 2002;21 (6): 673-6. J Ultrasound Med (full text) - Pubmed citation
- 5. Poster RB, Spirt BA, Tamsen A et-al. Complex tunica albuginea cyst simulating an intratesticular lesion. Urol Radiol. 1991;13 (2): 129-32. Pubmed citation
- 6. Images in Urology. Springer. ISBN:0857297686. Read it at Google Books - Find it at Amazon
- 7. Redman JF, Rountree GA. Bilateral cysts of tunica albuginea of testes. Urology. 1988;32 (3): 259-61. Pubmed citation
- 8. Chou SJ, Liu HY, Fu YT et-al. Cysts of the tunica albuginea. Arch. Androl. 2004;50 (2): 89-92. Pubmed citation
- 9. Poster RB, Spirt BA, Tamsen A et-al. Complex tunica albuginea cyst simulating an intratesticular lesion. Urol Radiol. 1991;13 (2): 129-32. Pubmed citation