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Tunica albuginea cyst

Last revised by Dr Jeremy Jones on 20 Sep 2021

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:

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