Ectasia of the Rete Testis with Ipsilateral Renal Agenesis

Abstract

Scrotal masses are a common problem in children. Cystic lesions usually are found to be hydroceles, while solid masses suggest the possibility of neoplasia. A rare cause of a cystic scrotal mass is ectasia of the rete testis. A review of the literature reveals only 1 case similar to the patient herein described. Both patients had agenesis of the ipsilateral kidney, which explained on the basis of the embryologic overlapping of the genitourinary system. Our patient bears clinical similarity to the ACI rat and correlation is made with this animal model system. Excision of the multiloculated rete testis cyst, rather than orchiectomy, appears to be curative.

Cystic Dysplasia of the Testis: A Very Rare Paediatric Tumor of the Testis

“…Of the cases presented in the literature, 19.4% (n = 6) had employed this approach to preserve the testicular endocrine function for development in childhood. While the patient reported by Fischer et al [3] had no recurrence of the cystic mass after 15 months, our patient and the patients reported by Noh et al [20] and Wojcik et al [8] developed new cysts after only a few months. For the reoperation, the testicle-sparing approach was chosen in 1 case, while the other urologists decided to perform orchiectomy.…”

“…Other causes of scrotal swelling include torsion of the testis, epididymo-orchitis and post-traumatic hematoma. Neoplasia should be suspected if the mass appears to be solid, or a multicystic mass with positive markers for testicular tumors (␣-fetoprotein and ␤-human chorionic gonadotropin) is found [3].…”

“…CDT is characterized histologically by the presence of multiple anastomosing cystic spaces which vary in size and shape, separated by connective tissue and lined by cuboidal cells [3]. The lesion is situated primarily in the mediastinum testis.…”

“…This seems to be the best solution in cases of rapidly growing cysts with compression of the testicular tissue [16]. But Fischer et al [3] point out that it is important to realize that this cystic lesion is benign and can be removed surgically, leaving the testis intact. Of the cases presented in the literature, 19.4% (n = 6) had employed this approach to preserve the testicular endocrine function for development in childhood.…”

Papillary adenocarcinoma of the rete testis: sonographic findings

“…1) A variety of cystic lesions of the testis have been described, including congenital simple cysts [4] and cystic dysplasia of the testis; the sonographic appearance of the latter was described by Cho and Kosek [5]. These dysplastic processes are described as having clear fluid with no nodular or solid components and cysts of varying size [4,6]. The great majority of testicular tumors are solid and predominantly hypoechoic on sonographic examination [7].…”