Intratesticular epidermoid cyst

Case contributed by Dr Callum Smith

Presentation

Painless lump in right testis.

Patient Data

Age: 30 years
Gender: Male
Ultrasound

There is a well circumscribed intratesticular mass at the upper pole of the right testis. The mass contains alternating hyperechoic and hypoechoic rings, demonstrating a lamellar ("onion skin") appearance. There is no vascularity within the testicular lesion. The surrounding testis is normal. These findings are suggestive of an intratesticular epidermoid cyst. 

Case Discussion

A 30-year-old man presented with a painless right testicular lump. Tumour markers were normal. He subsequently underwent orchidectomy. The diagnosis of an intratesticular epidermoid cyst was confirmed histologically.

Intratesticular epidermoid cysts are rare benign testicular tumours which account for 1% of testicular tumours. The typical appearance on ultrasound is a well circumscribed mass with a lamellar or "onion skin" appearance. The management of intratesticular epidermoid cysts is controversial. Previously radical orchidectomy was the gold standard, however, there is emerging evidence to suggest that the typical radiological appearance on ultrasound combined with negative tumour markers and a biopsy negative for intraepithelial neoplasia is sufficient to make the diagnosis. The patient may then undergo testicle sparing surgery 1-3

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Case information

rID: 54185
Case created: 26th Jun 2017
Last edited: 18th Jul 2017
System: Urogenital
Inclusion in quiz mode: Included

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