Testicular Epidermoid Cysts Research Articles

Testicular epidermoid cysts in children: sonographic characteristics with pathological correlation

Testicular epidermoid cyst is a rare benign tumor in children. Although this entity is widely described in adults in literature, there are no large series describing the pathological and radiological findings in children. Knowledge of the sonographic features seen in children may alter surgical treatment. To describe the specific US characteristics of testicular epidermoid cyst in children and to correlate these findings with pathology. All children with pathologically proven epidermoid cyst and preoperative sonograms diagnosed at a single children's hospital between 1978 and 2008 were included. For each child, the medical records, preoperative US and pathological specimens were reviewed and correlated. Eleven patients (ages 1-17 years old) met our criteria. Nine cysts had characteristic target or onion ring appearances, the youngest patient had a simple cyst-like lesion, one cyst had a heterogeneous appearance, and more than 80% of the cysts presented daughter cysts attached along the periphery of the main cyst. In addition to the commonly described findings of the epidermoid cyst (the target and onion ring appearances), simple cysts and the presence of daughter lesions are newly described findings that point to the diagnosis of this benign entity in children.

Multiple epidermoid cysts in the testis of a New Zealand White rabbit: A case report

Multiple epidermoid cysts were observed microscopically in the testis of a New Zealand White rabbit. The cysts were lined by stratified squamous keratinizing epithelium and filled with concentric layers of keratin. Testicular epidermoid cysts have been described in men but are very rare in animals.

Bilateral Testicular Epidermoid Cysts

Testicular epidermoid cysts are the most common benign tumors of the testes, but account for only 1-2% of all testicular tumors. In a young man presenting with a testicular mass, a high index of suspicion must be maintained for the malignant testicular germ cell tumor, which is 50-times more common than testicular epidermoid cyst. Bilateral testicular epidermoid cysts are a very rare condition, with only a few reports in the literature. It is extremely important in this condition to make a correct pre-operative diagnosis on imaging to enable a testis-sparing surgery.

Testicular Epidermoid Cyst on Diffusion-Weighted MR Imaging and ADC Map : A Case Report

Testicular epidermoid cyst is a rare benign tumor, accounting for 1-2% of all testicular tumors. It can be cured by organ preserving surgery, so accurate preoperative diagnosis is very important for preventing unneccessary and extensive orchiectomy. We experienced a case of an 18-year-old man who presented with a painless lump in his right testis. The testicular mass showed an onion ring sign on ultrasonography. Computed tomography images showed the mass as a low attenuating lesion with curvilinear calcification. On Magnetic resonance imaging (MRI), the mass appeared as high signal intensity with internal alternating low signal intensity patterns on T2-weighted images. The mass was displayed as having homogeneous high signal intensity on diffusion magnetic resonance imaging and showed lower apparent diffusion coefficient values than normal testis parenchyma, similar to intracranial epidermoid cysts. Testicular MRI with DWI and ADC map can help to more accurately diagnose testicular epidermoid cyst.

Case report of a testicular epidermoid cyst and review of its typical sonographic features

A case of testicular epidermoid cyst, demonstrating multiple characteristic sonographic patterns in a single lesion, is presented with a brief review of the distinctive ultrasound features. It is important to remember that the sonographic patterns describing testicular epidermoids represent the varied amounts and arrangements of keratin of a particular lesion. A given lesion may demonstrate subtle variability or more than one characteristic pattern at any given time. With this in mind, preoperative characterization of testicular epidermoids should allow for increasing utilization of testicular sparring surgery in the management of this benign lesion.

Epidermoid cyst: a rare intratesticular tumor in children

An 18-year-old boy presented with a palpable left testicular mass. Sonography demonstrated a circumscribed left intratesticular mass with concentric layers of alternating increased and decreased echogenicity (Fig. 1). There was no blood flow within the lesion with color Doppler interrogation (Fig. 2). Sonographic findings suggested a testicular epidermoid cyst, a diagnosis that was pathologically confirmed following surgical enucleation. Epidermoid cysts are rare benign tumors with no malignant potential that compose 1–2% of intratesticular masses in children [1]. Histopathologically, these lesions are lined by stratified squamous epithelium and filled with

Testicular Epidermoid Cysts

The purpose of this series was to describe the sonographic features of intratesticular epidermoid cysts with clinicopathologic correlation. A retrospective review of the sonographic features of all intratesticular epidermoid cysts within the radiologic pathology archive of the Armed Forces Institute of Pathology with correlation with clinical, surgical, and pathologic data was performed. On sonograms, intratesticular epidermoid cysts were evaluated for shape, borders, and the presence of characteristic features, including alternating hypoechoic and hyperechoic rings, mural calcifications, and echogenic central core. Color Doppler imaging was evaluated for the presence of internal flow. Of 21 cysts seen in 20 male patients (mean age, 24 years; range, 11-52 years), the most common finding was mural calcifications, which were seen in 18 lesions (86%). Concentric rings of alternating echogenicity were shown in 13 lesions (62%), and 7 cysts (33%) had an echogenic central core. No cysts showed internal vascularity. Testicular epidermoid cysts are uncommon solid-appearing testicular masses that usually present as palpable masses and are benign. Knowledge of the sonographic and pathologic features may help differentiate these lesions from malignancy and possibly prevent unnecessary orchiectomy.

Quiste epidermoide testicular

Introduction Testicular tumors are usually managed by radical orchiectomy because of the high incidence of malignant lesions. Epidermoid cyst of the testis is a rare benign tumor, and its differential diagnosis from malignant testicular tumors is difficult. Materials and methods The clinical records of seven patients who attended our hospital with testicular epidermoid cysts were reviewed. Preoperative evaluation consisted of testicular ultrasonography in 6 patients, and magnetic resonance imaging in 4 patients. A peroperative biopsy was performed in four patients. Results Ultrasonographic appearance was specific for diagnosis of epidermoid cyst in 80% of patients. Pathological diagnosis was made in all biopsies taken during surgery. Conservative management was (tumorectomy or partial orquidectomy) performed in 6 patients (85%). Conclusions Preoperative imaging findings, gross characteristics of the lesion, and peroperative biopsy results provide adequate information to attempt testis-sparing surgery instead of radical orchiectomy.

Testicular epidermoid cyst

IntroductionTesticular tumors are usually managed by radical orchiectomy because of the high incidence of malignant lesions.Epidermoid cyst of the testis is a rare benign tumor, and its differential diagnosis from malignant testicular tumors is difficult. Materials and methodsThe clinical records of seven patients who attended our hospital with testicular epidermoid cysts were reviewed.Preoperative evaluation consisted of testicular ultrasonography in 6 patients, and magnetic resonance imaging in 4 patients. A peroperative biopsy was performed in four patients. ResultsUltrasonographic appearance was specific for diagnosis of epidermoid cyst in 80% of patients. Pathological diagnosis was made in all biopsies taken during surgery.Conservative management was (tumorectomy or partial orquidectomy) performed in 6 patients (85%). ConclusionsPreoperative imaging findings, gross characteristics of the lesion, and peroperative biopsy results provide adequate information to attempt testis-sparing surgery instead of radical orchiectomy.

Intratesticular Epidermoid Cyst: A Rare Tumor

Testicular epidermoid cyst is extremely rare injury, which in recent studies has been regarded as a tumor. Some authors consider this lesion as a cystic monodermal teratoma, the histogenesis remains controversial. In this study we provide clinical and morphological characteristics of an epidermoid cyst in the left testicle in a 16 years old patient, where apparently a nodular lesion in the left testicle was detected.KeywordsCyst; Epidermoid; Intratesticular

Double Testicular Epidermoid Cysts in a young adult: A case Report

Testicular epidermoid cysts are uncommon benign tumours representing approximately1% of all resected testicular masses. Ultrasonography is a useful tool to suggest its benignity and therefore, orchitectomy can be avoided. We describe a case in which there were two epidermoid cysts in right testes. With extensive literature research, we could find only five cases of more than one epidermoid cyst in one testis. I believe this will be the sixth case only. CASE REPORT A 20yrs old male presented to the surgical out patient department with a history of swelling of right testes for last threefour weeks only. On clinical examination right testes showed mild swelling but no redness. No signs of hydrocoele elicited. Ultrasound (US) examination showed two target lesions measured about 9.0mm and 5.0mm size each around lower pole of right testes. Both the lesions were lying side by side. No Doppler flow identified through the mass. A provisional diagnosis of epidermoid cyst was suggested. The left testis was unremarkable. Epididymus were normal on both sides. Unfortunately, the surgeon was not convinced with our provisional diagnosis. Therefore, orchitectomy was carried out. The pathological specimen confirmed the ultrasonographical diagnosis. DISCUSSION Epidermoid cyst was first described in1942. Since than more than two hundred cases have been reported in the literature. In the majority of cases the lesion showed varied characteristics of ultrasound appearance. The changes varied from hyperreflectivity of wall to hyporeflectivity. The contents varied from pure cystic nature to target lesions or in the form of concentric rings. Histopathological findings showed two circular sharply demarcated area of white tissue, the largest measures8mm in diameter. Section of circular tissue show central keratin squamous surrounded by well-differentiated squamous epithelium. The findings are consistent with epidermoid cyst. Figure 1 Figure 1: Pathological specimen shows central keratin squamous surrounded by well-differentiated squamous epithelium. Double Testicular Epidermoid Cysts in a young adult: A case Report 2 of 3 Figure 2 Figure 2: Ultrasonography shows Target lesions noted in right testes Figure 3 Figure 3: Same Testes in transverse section shows target lesions side by side.

Quiste epidermoide testicular

Testicular epidermoid cysts are rare and can be clinically misleading with other testicular neoplasms. We describe a case of epidermal cyst of the testis, with the aim to contribute to the clinicopathological knowledge of this entity. A 24-year-old caucasian man presented with a self-detected right testicular mass. Ultrasound features were consistent with solid tumor. He underwent an inguinal radical orchyectomy. An intraparenchymal cyst measuring 1,4 cm was observed, covered by epidermal epithelium with no other skin components. Adnexal testicular pulp was normal. When a preoperative diagnosis is made, a conservative treatment is recommendable, including frozen sections analysis of the cyst and adjacent testicular parenchyma to rule out a coexistent intratubular germ cell neoplasia.

The diagnostic and treatment of testicular epidermoid cyst

目的 探讨睾丸表皮样囊肿的临床表现、诊断和治疗方法.方法 回顾性分析2例睾丸表皮样囊肿的临床诊治资料并结合相关文献复习讨论.结果 2例患者,1例误诊为睾丸精原上皮细胞瘤,手术切除睾丸;1例术中快速冰冻切片病理检查明确诊断,行肿瘤剜除术.术后常规病理检查均确诊为睾丸表皮样囊肿.随访3年,2例均未见复发和转移.结论 睾丸表皮样囊肿是临床上少见的良性肿瘤,多无症状或仅有轻微疼痛.超声和MRI可初步筛查,术中快速冰冻切片病理检查可为手术提供信息,手术剜除肿瘤是其主要治疗方法。

Clinical and Pathological Features Associated With the Testicular Tumor of the Adrenogenital Syndrome

Testicular tumor of the adrenogenital syndrome is a rare clinical entity found in young men with endocrine disorders. Histologically it resembles Leydig cell tumor. We 1) reviewed the clinical features of testicular tumor of the adrenogenital syndrome and 2) determined if special histopathological features of the tumor and synaptophysin reactivity could distinguish testicular tumor of the adrenogenital syndrome from Leydig cell tumor. We reviewed the medical and pathological records for all patients with testicular tumor of the adrenogenital syndrome seen at our institution from 1978 to 2004. These tumors were examined by histological and immunophenotypic methods for comparison to Leydig cell tumor. A total of 14 males with an endocrine disorder had pathological evidence of testicular tumor of the adrenogenital syndrome. These tumors were often bilateral (93% or 13 of 14 cases), associated with pain (92% or 12 of 13) and refractory to medical management with high dose exogenous steroids (93% or 13 of 14). Testicular tumor of the adrenogenital syndrome was managed by tumor enucleation in 7 patients (54%) and by radical orchiectomy in 6 (46%). All patients had resolution of pain at 3-month followup. Upon histological review features found to be more common to testicular tumor of the adrenogenital syndrome compared with Leydig cell tumor were nuclear pleiomorphism, low mitotic activity, extensive fibrosis, lymphoid aggregates, adipose metaplasia and prominent lipochrome pigment. Synaptophysin (ICN, Costa Mesa, California) reactivity was strong in testicular tumor of the adrenogenital syndrome but rarely observed in Leydig cell tumor. In our series medical treatment failed in patients with testicular tumor of the adrenogenital syndrome and conservative surgical therapy was possible in select individuals. We identified special histopathological and immunophenotypic features, including synaptophysin staining, which distinguish testicular tumor of the adrenogenital syndrome from Leydig cell tumor.

Interphase Fluorescence In situ Hybridization Analysis of Chromosome 12p Abnormalities Is Useful for Distinguishing Epidermoid Cysts of the Testis from Pure Mature Teratoma

The distinction of epidermoid cyst of the testis from teratoma is of critical importance because the former is benign and the latter is a malignant tumor that may have associated metastasis of either teratomatous or non-teratomatous germ cell tumor types. Chromosome 12p abnormalities are seen in the vast majority of testicular germ cell tumors of adults and are present in all histologic subtypes. In this study, we investigated the clinical utility of interphase fluorescence in situ hybridization (FISH) analysis of chromosome 12p abnormalities for distinguishing epidermoid cysts of the testis from pure mature teratoma. Sixteen testicular epidermoid cysts and 17 testicular teratomas were investigated for isochromosome 12p [i(12p)] and 12p overrepresentation using interphase FISH analysis. Neither i(12p) nor 12p overrepresentation were observed in 16 epidermoid cyst cases, whereas i(12p) was detected in 76% of teratomas and 12p overrepresentation was identified in 29% of teratomas. Overall, 88% of testicular teratomas had chromosome 12p abnormalities. FISH identification of i(12p) and/or 12p overrepresentation in routinely processed surgical specimens is a useful ancillary diagnostic tool in distinguishing testicular epidermoid cysts from teratoma.

Testicular epidermoid cyst in Klinefelter's syndrome

A 38-year-old Japanese man was referred to our outpatient clinic for treatment of infertility. Semen analysis showed azoospermia. Chromosome analysis revealed a 47XXY karyotype, and non-mosaic Klinefelter's syndrome (KFS) was diagnosed. Upon physical examination, the patient's right testicular volume was 30 mL and the left testicular volume was 3 mL. Laboratory tests showed normal levels of lactate dehydrogenase, alpha-fetoprotein, and human chorionic gonadotropin beta-subunit. The plasma luteinizing hormone and follicle-stimulating hormone levels were increased to 15.7 mIU/mL and 45.9 mIU/mL, respectively. The plasma testosterone was decreased to 0.25 ng/mL. Magnetic resonance imaging showed a right testicular mass of low-signal intensity on the T1-weighted image and of high-signal intensity on the T2-weighted image. Therefore, the final diagnosis was KFS with a right testicular tumor. Thus, a right high orchiectomy was performed. Histological examination revealed an epidermoid cyst of the right testis. Epidermoid cysts in cases of KFS are rare. To our knowledge, only seven cases, including ours, have been reported in the literature.

Testicular epidermoid cyst and organ preserving surgery

Epidermoid cyst is a rare and non-teratomatous, benign tumour of the testis. Testis-sparing surgery is recommended as surgical treatment. We present a 9-year-old-boy with testicular epidermoid cyst. The embryology, histogenesis and treatment of epidermoid cyst of testis, are discussed.

Epidermoid cyst of the testicle: unusual magnetic resonance imaging findings

Epidermoid cyst of the testis is an uncommon benign tumor that can be treated by organ-preserving surgery when diagnosed preoperatively. Although some sonographic characteristics may be suggestive of epidermoid cysts, sonography is not completely diagnostic. Magnetic resonance imaging (MRI) findings may provide support for the diagnosis of epidermoid cysts. The MRI findings of testicular epidermoid cysts have been reported as either bull's eye or target in appearance, or with signal intensity characteristics more typical of a cystic lesion. In this paper, we present typical sonographic and unusual MRI findings of a testicular epidermoid cyst.

Epidermoid cyst in a solitary testis: A case for non-surgical management

This is a case report of a 71-year-old man who presented with an incidental finding of a mass in a solitary right testis. A scrotal ultrasound scan showed the typical features of a testicular epidermoid cyst. Tumour markers were not elevated and the patient was managed non-operatively. On reviewing the literature, we found no previous report on the non-operative management of testicular epidermoid cysts

Heterotopic ossification in testicular microlithiasis

t F f n s 31-year-old married Chinese man with chronic hepatitis B presented with a 1-month istory of productive cough and night sweating, ollowed by testicular tenderness. The hormonal evels of beta-human chorionic gonadotropin, tesosterone, and alpha-fetoprotein were within noral limits. Sputum culture revealed Mycobacteium tuberculosis. Testicular sonography demontrated bilateral testicular microlithiasis and a ight-side intratesticular calcified nodule (8.5 mm) Fig. 1). Testicular microlithiasis with calcified tuerculoma1 or tumoral calcification was suspected efore surgery. Instead of orchiectomy, enucletion of the calcified nodule with testicular biopsy as performed, revealing an intact tunica albugnea and epididymis. Histologically, the well-dened nodule showed ossification and calcification ith peripheral, laminated basophilic materials Fig. 2). Immunohistochemical examination of cyokeratin revealed surrounding keratin and residal epithelial cells (Fig. 3). It was consistent with a ase of testicular epidermoid cyst with heterotopic ssification in testicular microlithiasis. Heteroopic ossification is the presence of bone in soft issue where bone normally does not exist. Microithiasis can be associated with both malignant and enign conditions,2 but has never been reported ith heterotopic ossification. Extremely rarely, eterotopic ossification has been reported in assoiation with a number of testicular lesions, includng Leydig cell tumor,3 primary mucinous tumor, eminoma,4 and dermoid/epidermoid cysts.5 To ur knowledge, this is the first report of a calcified esticular epidermoid cyst in a patient with testicuar microlithiasis. The condition should not be conused with a testicular malignancy. The patient was ell at the 3-month follow-up visit.