A 30-year-old man presented with a painless right testicular lump. Tumor markers were normal. He subsequently underwent orchiectomy. The diagnosis of an intratesticular epidermoid cyst was confirmed histologically.
Intratesticular epidermoid cysts are rare benign testicular tumors which account for 1% of testicular tumors. 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 orchiectomy was the gold standard, however, there is emerging evidence to suggest that the typical radiological appearance on ultrasound combined with negative tumor markers and a biopsy negative for intraepithelial neoplasia is sufficient to make the diagnosis. The patient may then undergo testicle sparing surgery 1-3.