Torsion of an Epididymal Cyst: A Rare Finding on Scrotal Exploration for Acute Scrotum

Abstract

Torsion of epididymal cyst (EC) is an exceedingly rare cause of acute scrotum in both children and adults. We add our case as the ninth case to literature which was an 8-year-old child presented with features of acute scrotum with history of EC on conservative management. Doppler sonography showed perfused normal bilateral testes and a 4.1 × 1.7 cm septate cystic lesion of right epididymis. On scrotal exploration, we found a haemorrhagic cystic lesion attached to the upper pole of right testis and twisted for 540 degrees with normal testis and appendage. Cyst was excised, and histopathology revealed a haemorrhagic EC. Our case was peculiar due to, presenting as acute scrotum in a child of 1-10 years age group who was conservatively managed for right-sided EC and presence of 540 degrees torsion.

Torsion of epididymal Cyst as a cause of acute Scrotum in a child

“…2 As far as we know, only nine cases have been reported in Literature. 4 It is the third case of a right-sided EC with acute scrotum presentation 1 , 4 and the remaining previous seven cases are left-sided lesions. 3 , 5 Most of the torsed EC patients are older than 10-year-old boys.…”

“… 1 In most cases with EC conservative management has been suggested, but in the setting of acute scrotum further evaluation is required. 4 Color Doppler ultrasonography is the modality of choice for differentiating the causes of the acute scrotum from one another. 2 As far as we know, only nine cases have been reported in Literature.…”

“…EC can become painful and require surgical or medical treatment in rare conditions, such as infection, trauma, or torsion. 1 , 4 EC torsion is very rare and to the best of our knowledge, only 9 cases have been reported in the literature. 4 …”

“… 1 , 4 EC torsion is very rare and to the best of our knowledge, only 9 cases have been reported in the literature. 4 …”

Atypical Case of Testicular Torsion in a Child (Clinical Observation)

“…(1987), КПЯ возникает в результате прогрессирующего расширения рудиментарных элементов, которые не сообщаются с секреторными протоками придатка яичка [10]. По данным многих исследований, предрасполагающим фактором к развитию КПЯ является наличие в анамнезе крипторхизма, муковисцидоза, болезни Гиппеля -Линдау, инфекции мочевыводящих путей или травмы органов мошонки [4,9]. Аспирация содержимого кисты и ее гистологическое исследование является единственным методом дифференциации этих включений.…”