Testicular epidermoid cyst: A rare entity - Case report

Abstract

Introduction and importance: Epidermoid cysts (ECs) of the testicle are rare benign lesions that can mimic more serious testicular masses. Accurate diagnosis is essential for proper management, often requiring surgical intervention to confirm the nature of the mass.

Case presentation: A 21-year-old male presented with chronic pain in his right scrotum. Physical examination revealed a firm mass within the right testis. Ultrasound and MRI findings were consistent with an intratesticular EC. The patient underwent partial orchidectomy for further evaluation and treatment.

Clinical discussion: Histopathological analysis confirmed the diagnosis of an epidermoid cyst, characterized by a well-defined lesion with keratin-filled cystic spaces. The differential diagnosis for testicular masses includes both benign and malignant conditions. Imaging alone may not be sufficient to distinguish between these possibilities, making surgical exploration and histopathological examination necessary for definitive diagnosis.

Conclusion: This case highlights the importance of considering epidermoid cysts in the differential diagnosis of testicular masses in young males. Surgical intervention, such as partial orchidectomy, not only provides a definitive diagnosis but also serves as a therapeutic measure. The patient had an uneventful postoperative recovery, emphasizing the efficacy and safety of the surgical approach in such cases.

Keywords: Partial orchidectomy; Scrotal ultrasound; Testicular benign tumor; Testicular epidermoid cyst.

Fig. 1

Scrotal ultrasound of the right testicle demonstrating a heterogeneous intratesticular mass with multilayered organization (yellow arrow), surrounded by normal testicular parenchyma (white arrow). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

Fig. 2

MRI of the testicles revealing a well-defined nodule in the midportion of the right testicle (yellow arrow), with heterogeneous signal intensity and concentric rings on T1 (C) and T2 (A) sequences suggestive of an epidermoid cyst. The left testicle appears normal. Additional images show the epidermoid cyst (yellow arrow) on T1 FS fast signal (B), T2 FS (D), coronal T2 (E), diffusion-weighted imaging (F), and apparent diffusion coefficient (ADC) mapping (G). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

Fig. 3

Intraoperative photograph showing the excision of the epidermoid cyst (EC) from the middle of the right testis. The cystic lesion is well-encapsulated and firm (yellow arrow), originating from the testicular parenchyma (with arrow) and surrounded by the albuginea (black arrow). Picture B shows the excised epidermoid cyst. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)