Epidermoid cysts of the testis: A report of three cases and an analysis of 141 cases from the world literature

Abstract

Epidermoid cysts of the testis are rare and represent about 1% of all testicular tumors. An analysis of 141 cases reported to date in the world literature, including the cases reported here, indicates that 50% of the lesions occur in the third decade and 86% between the second and fourth decade. The most common presentations are painless enlargement of the testis (41%) for an average period of 2.25 years or incidental detection during routine physical examination (33%). Clinically, a discrete testicular nodule can be palpated in the majority of the cases (76%). Pathologic findings are those of a squamous lined cyst containing keratin with absence of appendages or other elements. It is believed that, despite the benign nature of the lesion, they should be treated by orchiectomy so that a thorough pathologic examination can be done to establish a confident diagnosis. While some controversy exists about their source of origin, all the evidence, including the age, more common occurrence among whites, and the rare reported cases arising in cryptorchid testis points to a germ cell origin for these lesions. The epidermoid cyst should thus be recognized as another subtype in the category of germ cell tumors of the testis and perhaps the ovary.

Epidermal Inclusion Cyst Presenting as a Palpable Scrotal Mass

“…EIC are benign tumors consisting of a sac lined by stratified squamous epithelium filled with laminated keratin, cholesterol crystals, and debris [2]. The cysts are usually asymptomatic unless they become large enough to interfere with function, become infected, or rupture causing inflammation of adjacent structures [2].…”

“…The cysts are usually asymptomatic unless they become large enough to interfere with function, become infected, or rupture causing inflammation of adjacent structures [2]. Usually these masses are midline and most reports place them along the median raphe.…”

“…These EIC are usually located along the midline and have been reported from the distal penis to the anus [1]. The presentation in the scrotum is usually an asymptomatic, firm, freely moveable extra-testicular mass developing between the second and forth decade of life [2]. We report a case of an extra-testicular epidermoid inclusion cyst with an atypical presentation away from the midline as well as a review of the diagnosis, evaluation and management of these unique scrotal anomalies.…”

Primary Squamous Cell Carcinoma in the Testis: A Case Report

“…Epidermal cyst of the testis is rare, and it accounts for less than 1% of all testicular neoplasm (6). Epidermal cyst of the testis is usually known to take a benign clinical course.…”

Testicular epidermoid cyst: A rare case

“…[ 1 ] However, testicular epidermoid cysts are a rare cause of testicular pathology responsible for 2.1% of all testicular masses. [ 2 3 4 ] Both germ cell tumors and epidermoid cysts are seen most commonly in Caucasians, within the second to fourth decade of life. [ 2 3 ] In comparison, germ cell tumors are of malignant etiology and are responsible for 95% of testicular lesions.…”