Bilateral epidermoid cysts of the testis: Sonographic and MRI findings

Abstract

Epidermoid cysts of the testis are rare benign lesions, without malignant potential, that can be managed conservatively with cyst enucleation and testis-sparing surgery. Bilateral epidermoid cysts in the testes have been reported very infrequently. We report the sonographic and MRI findings in a patient who presented with a palpable nodule in only 1 testis, but in whom sonography showed bilateral lesions. On sonography, the cysts had an internal "onion-ring" structure; color Doppler signals were absent. On MRI, the cysts had a laminated appearance, with alternating low- and high-signal-intensity areas on T2-weighted images. These imaging findings and the negative results of laboratory tests for tumor markers suggested the correct diagnosis, and testis-sparing surgery could be performed.

Epidermoid Cyst and Teratoma of the Testis

“…It has been reported that most tumors larger than 1.6 cm show internal color Doppler signals 23 and that a lack of internal vascularity in tumors of this size is more suggestive of benign lesions. 7 However, none of the teratomas in our series, including 2 that were 2.5 and 1.8 cm, respectively, in diameter, showed blood flow on color or power Doppler examinations.…”

Clinics in diagnostic imaging (149)

“…(1,2) Bilateral testicular epidermoid cysts are even rarer, and to our knowledge, only 15 patients have been reported in the English literature. (3)(4)(5)(6) Multiple cysts have been reported in patients with Gardner syndrome, Klinefelter syndrome and cryptorchid testes. (7,8) The age of affected patients range from 3 to 77 years, with the majority in the second to fourth decades of life.…”

Bilateral Testicular Epidermoid Cysts

“…Bilateral TEC is a very rare condition, with only a few reports in the literature. [16–19] In all, pre-operative imaging suggested the correct diagnosis and testis-preserving surgery, using enucleation or wedge resection, was performed for most of the involved testes. Bilateral TEC presents a unique challenge in treatment as the previously accepted protocol would entail bilateral orchiectomy.…”