Clinics in diagnostic imaging (149). Bilateral testicular epidermoid cysts

Abstract

A 33-year-old man presented with a painless, non-growing left testicular mass for five years. Preoperative ultrasonography (US) of the scrotum showed a small, circumscribed calcific mass in the right testis and another well-defined heterogeneous echoic mass with a partially calcified wall in the left testis, with avascularity on colour Doppler US. These imaging findings in a clinical setting of non-growing testicular masses were highly suggestive of epidermoid cysts, thus leading to testis sparing surgery. Histopathology confirmed bilateral epidermoid cysts. To the best of our knowledge, only 15 cases of bilateral epidermoid cysts have been reported. We discuss the US features of epidermoid cyst and its surgical management, as well as various cases of testicular masses.