Benign scrotal masses in children - some new lessons learned

Abstract

Introduction: A preponderance of benign intratesticular masses in pre-pubertal males encourages testicular-sparing surgery (TSS).

Objective: To review outcome of benign testicular lumps in children managed at a tertiary pediatric center more than 7.5years.

Methods: A retrospective review of pediatric benign testicular lesions from January 2008 to June 2015 was performed.

Results: There were twelve benign intratesticular tumors. Of these, 11 were in pre-pubertal males; comprising four teratomas, two epidermoid cysts, one dermoid cyst, two cases of Leydig cell hyperplasia, one cystic dysplasia of the rete testis and one large simple intratesticular cyst. We illustrate a case of Leydig cell hyperplasia presenting with precocious puberty limited to the ipsilateral hemi-scrotum. TSS was attempted in all 11 pre-pubertal cases, but successfully performed in seven. TSS was possible for a large testicular cyst seemingly replacing the entire testis, with evidence that the testis reconstituted itself after surgery. Recurrence of an epidermoid cysts reported.

Conclusion: For the first time in the literature, this series reports Leydig cell hyperplasia presenting with ipsilateral hemi-scrotal changes of precocious puberty; shows evidence that the testis reconstitutes itself after TSS for a large cyst; and reports recurrence of an epidermoid cyst after TSS.

Keywords: Benign; Pediatrics; Testicular sparing surgery; Testicular tumor.