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Objective: This study aims to examine the clinical characteristics and surgical management of pediatric testicular epidermoid cysts, thereby contributing to the existing body of knowledge pertinent to the diagnosis and therapeutic intervention s for this condition., Methods: A retrospective analysis was conducted on the clinical records of 23 pediatric patients diagnosed with testicular epidermoid cysts, who were admitted to our institution between April 2013 and February 2024. Concurrently, a comprehensive review and analysis of pertinent literature were undertaken to augment the findings., Results: The mean age at which the onset of epidermoid cysts was observed was 6.0 years. All cases were singular and unilateral. B-ultrasound diagnosis categorized 6 cases as epidermoid cysts, 11 as teratomas, and 6 as indeterminate, yielding a diagnostic sensitivity of 26.1%. All patients underwent testicle-sparing mass resection, and nine patients underwent rapid intraoperative frozen section analysis, revealing eight cases of testicular epidermoid cysts and one teratoma, with a diagnostic sensitivity of 88.89%. Postoperative histopathological examination confirmed the diagnosis of testicular epidermoid cyst., Conclusions: Pediatric testicular epidermoid cysts are an uncommon occurrence, primarily presenting as a painless scrotal mass, which can mimic the clinical features of malignant testicular tumors. Imaging modalities and histopathological assessment are pivotal in the diagnostic process for pediatric testicular epidermoid cysts. For cases where B-ultrasound is inconclusive, rapid intraoperative pathological examination should be considered., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

We present the case of a 22-year-old male that comes to the Urology clinic with the incidental finding of a testicular mass. Typical findings in echography will guide us towards the diagnosis of an epidermoid cyst. 1 , 2 This type of infrequent benign tumor is responsible for only around 2% of all testicular tumors. 1 Because of this low incidence literature regarding epidermoid cysts is scarce. Treatment has been susceptible to change throughout the years. 6 In this clinical case we challenge readers to review a rare tumor and to choose the most appropriate treatment for our patient., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Epidermoid cysts, which constitute 1% of all testicular tumors, are considered to be benign even though histogenesis is not clear. Patients usually suffer from painless scrotal mass or this mass is realized during the routine physical examination. Hematospermia may be a finding for both benign and malignant testicular tumors. Many authors advocate the testicular sparing surgery in the treatment but epidermoid cysts are usually treated with radical inguinal orchiectomy, because of the difficulties in the diagnosis, concurrence of the malignant tumors, and the debate on the histogenesis.

Objectives: In this study, we aimed to define the clinico-radiological data and treatment options for intratesticular epidermoid cysts (IEC). MATERIALS AND METHODS: We retrospectively reviewed the medical records of the patients that under went surgery for testicular mass between 1995 and 2017. Data of the patients whose histopathological evaluation revealed IEC were recorded.  RESULTS: A total of 20 patients with IEC were identified.While three of 20 patients were excluded due to incomplete data, the remaining 17 patients with pathologically proven IEC were reviewed and analyzed in the study. The mean patient age was 22.2 years (range, 17-29 years). All patients were presented with painless testicular swelling and/or mass. Serum tumor markers of all patients were within the ranges. Four patients treated with radical orchiectomy (23.5%), while 13 patients under went partial orchiectomy (76.5%). The mean size ofthe IEC was 17.7x15.1 mm (range, 26x10 mm). IEC swere mostly located in the middle pole of the testes (10of 17 patients, 58.8%). CONCLUSIONS: This study is designed in retrospective nature, but the patient population is one the largest reported in the literature. According to our study, we can easily state that partial orchiectomy can be performed safely after FSA in patients that have IECs.

Epidermoid cyst of the testis is a benign, non-teratomatous tumour. It is often possible to make the diagnosis pre-operatively, combining typical sonographic features with normal biochemical tumour markers. The accurate pre-operative diagnosis will allow for testis-sparing surgery and prevent unnecessary orchiectomy. An 11-year-old boy with testicular epidermoid cyst who presented with pain in testis was presented in this report.

Objective: To investigate the MRI characteristics and differential diagnosis of testicular epidermoid cyst., Methods: The MRI imaging features of 7 testicular epidermoid cyst cases were retrospectively analyzed and compared with that of testicular seminoma. All cases were examined by contrast-enhanced MRI scans., Results: The group of 7 cases of testicular epidermoid cyst MRI showed characteristic: On T₁-weighted MR images, some lesions showed low signal-based, center with spotty high signal ("target sign"). On T₂-weighted MRI, some lesions had a laminated appearance, with alternating low and high signal intensity areas ("onion skin" sign). On contrast-enhanced images, all lesions were sharply demarcated low signal intensity masses, and contrast enhancement were not seen in any of the cases., Conclusion: MRI characteristics of testicular epidermoid cyst are distinctive in certain extent. It may express "target sign", "onion skin" sign, T₂ low signal intensity complete rings, and without enhancement.

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., (Copyright © 2011 Elsevier GmbH. All rights reserved.)

We present the case of a boy with antenatally diagnosed bilateral testicular microlithiasis. Following annual surveillance the child developed metachronous bilateral epidermoid cysts. These were subsequently excised with testicular sparing surgery. Currently, there are only three cases of bilateral epidermoid cysts in the paediatric population, and none have been associated with testicular microlithiasis. This reignites the discussion regarding the histogenesis of epidermoid cysts and how its pathophysiology might relate to testicular microlithiasis.

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.

We report on a case of testicular mass with classic radiographic appearance for epidermoid cyst.

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.

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 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., (Copyright 2004 Wiley Periodicals, Inc.)

Epidermoid cyst is a rare benign tumor of the testes. The records from the last 20 years of Taiwanese patients in whom a testicular tumor was diagnosed were reviewed retrospectively. Patients with a confirmed epidermoid cyst of testis were evaluated for age, clinical assessment and follow-up. Among a total 146 testicular tumors, 28 (19%) patients had a benign tumor including 15 patients (10%; mean age 23 years, range 17-32 years) with an epidermoid cyst diagnosed pathologically. Pre-operative suspicion of the benign nature of the lesions was supported by testicular ultrasonography in 11 patients. Seven patients underwent magnetic resonance imaging after which benign epidermoid cyst was impressed in five patients. A testicular-sparing operation was performed in 12 patients after frozen sections confirmed the diagnosis. Three patients were treated by radical orchiectomy. There was no relapse after a median follow-up of 42 months (range, 2-82 months). Ultrasonography and magnetic resonance imaging of the scrotum may allow the diagnosis of epidermoid cyst of the testes to be made pre-operatively. The absence of relapse in these patients further supports the use of organ sparing surgery in these young men.

Epidermoid cyst of the testis, extremely rare in children, is a non-teratomatous benign tumor, and testis-sparing surgery should be the treatment of choice. To prevent unnecessary orchiectomy, recognition of this rare tumor in children is essential.

Epidermoid cysts of the testicle are rare, benign lesions that are clinically indistinguishable from malignant germ cell tumors. A scrotal mass in a 27-year-old man was incidentally detected by his family physician, and confirmed to be intratesticular by ultrasound. Radical orchidectomy was performed revealing the pathologic diagnosis. The presentation, evaluation and management of epidermoid cysts are discussed.

Epidermoid cysts of the testis are rare in children (3% of all the testicular tumors). Bilateral appearance has only been described in the pediatric age in 2 cases and none associated to Klinefelter's syndrome. We present, for our knowledge, the first case of bilateral epidermoid testicular cyst associated to klinefelter's syndrome in a boy, highlighting its management and therapeutic approach. We analyze the different kinds of treatment.

Epidermoid cyst of the testis is a rare benign tumour. The diagnosis is strongly suggested by ultrasound and MRI. Conservative surgery is possible in the case of a small isolated lesion and requires intraoperative histological confirmation. It is a constantly benign tumour that must be distinguished from testicular teratomas, justifying the search for associated neoplastic contingents requiring orchidectomy.

Objective: To define the clinical criteria and complementary investigation results allowing conservative surgery for epidermoid cysts of the testis., Materials and Methods: 16 patients with epidermoid cyst were managed in our department. Assessment of each patient included clinical examination, tumour marker assay and imaging (scrotal ultrasound in 16 cases and MRI in 2 cases). All patients were operated via an inguinal incision with primary clamping of the cord. No patient was lost to follow-up., Results: Tumourectomy was performed in 3 patients after frozen section histological examination confirmed the diagnosis of epidermoid cyst. No disease progression was observed with a mean follow-up of 57 months (range: 3 to 108 months)., Conclusions: Conservative surgery for epidermoid cyst is possible on the basis of precise criteria: typical ultrasound (or MRI) image, size less than 2 centimetres, normal tumour marker assays, frozen section histological examination confirming the diagnosis.

A 79-year-old man visited our clinic with complaints of left scrotal swelling. Ultrasonography revealed solid tumor with heterogeneous echogenicity. No other abnormal findings were observed including tumor markers. However, the tumor was very large and the diagnosis of malignant testicular tumor could not be excluded. Therefore, orchiectomy was performed. Histological diagnosis was 820-gram epidermoid cyst of the left testis.

Objective: To report two cases of epidermoid cyst of the testis, with special reference to the diagnostic and therapeutic aspects, and to review the literature., Methods: Two cases of epidermoid cyst of the testis are presented: one patient consulted for testicular swelling and the other for supraclavicular lymphadenopathy., Results: In both cases the pathological diagnosis was testicular epidermoid cyst., Conclusions: Testicular epidermoid cysts are uncommon. High frequency ultrasonography is a reliable diagnostic imaging method. Treatment by tumor enucleation with preservation of the testis is advocated, when possible.

Epidermoid cysts of the testis are rare benign intratesticular lesions, representing about 1-2% of all intratesticular tumors. In the English literature, the total reported number of patients with an epidermoid cyst is approximately 300. Almost all of the previous reports were of a single lesion in a testis and the occurrence of epidermoid cysts in cryptorchid testis was extremely rare. Herein, we report on a patient with multiple epidermoid cysts in a cryptorchid testis following orchiopexy. Because the cysts arose in a cryptorchid testis and occupied most of the space of the testis, orchiectomy was performed.

Objective: The purpose of this study is to analyze the sonographic and MR imaging findings of testicular epidermoid cysts., Conclusion: Sonographic findings of a markedly heterogeneous intratesticular mass with or without alternating hypo- and hyperechoic layers surrounded by a hypoechoic or echogenic rim and the absence of flow on color Doppler sonography suggest the preoperative diagnosis of testicular epidermoid cysts. T2-weighted MR imaging findings of a high-signal-intensity mass with or without low-signal-intensity foci surrounded by a low-signal-intensity rim and the absence of enhancement on contrast-enhanced T1-weighted MR images can strengthen the preoperative diagnosis. These imaging findings can offer a basis for surgeons to attempt testis-sparing surgery instead of orchiectomy.

The series comprises 6 patients (mean age, 21 years) who presented with an epidermoid cyst of the testis between 1991 and 1998. Pre-operative ultrasonography suggested the presence of a testicular cancer in 3 patients who underwent a radical orchidectomy. The ultrasound successfully predicted the true diagnosis in 3 patients who had a wedge excision of the cyst together with a cuff of normal surrounding tissue. All patients are free of disease with a mean follow-up of 3 years. With increasing awareness of the condition coupled with accurate pre-operative radiological imaging, local excision of an epidermoid cyst with preservation of the remainder of the testis is now a feasible and rational alternative to more radical surgery.

Objective: The purpose of this study is to analyze the appearance of testicular epidermoid cysts on high-resolution sonography and MR imaging and correlate imaging features with histopathologic findings., Conclusion: Intratesticular epidermoid cysts may show imaging features that correlate with their histopathologic findings. Concentric rings of alternating hypo- and hyperechogenicity on sonography and alternating high and low signal intensity on MR imaging ("onion ring" appearance) correspond to the pathologic finding of multiple layers of keratin debris. Absence of flow on color Doppler sonography and absence of contrast enhancement on MR imaging is also consistent with the avascular nature of these lesions. The ability of preoperative imaging studies to suggest the diagnosis of epidermoid cyst may prompt a testis-sparing surgery instead of an orchiectomy.

Benign and malignant testicular tumors are rare in infancy. Moreover, only a few cases of bilateral testicular tumors in children have been reported to date. To our knowledge, we report the first case of an asynchronous bilateral simple testicular cyst and testicular teratoma in an infant. This case demonstrates that although both lesions are benign in the prepubertal child, treatment decisions should be made carefully.

Epidermoid cysts os the testes have an incidence between 1-2% of total tumours in that organ. The embryonary origin of this benign neoplasia is unknown, although the most widely accepted theory is they are monodermal teratomas. Differential diagnosis with germinal cells is established through the characteristic dartboard-like ultrasound image, which allows testicular conservant surgery though only in the case of certainty about the lesion. Since that was not the case and given the ultrasound variability recorded in the literature, radical orchiectomy was performed to overcome the persistent doubt at staging the tumour's benignancy.

A 21-year-old man was admitted with a painless mass in the left testis. Physical examination revealed a firm, small-finger sized, mass lesion with a smooth surface in the left testis. The ultrasonographic appearance was a hypoechoic lesion with an echogenic rim in the left testis. Magnetic resonance imaging (MRI) findings showed the echogenic rim to be a low-signal zone on both T1 and T2-weighted images. The center, on T2-weighted images, had a low signal intensity, with peripheral high signal intensity. Under a preoperative diagnosis of epidermoid cyst, the mass was resected surgically with preservation of the testis. Histopathological diagnosis confirmed an epidermoid cyst. Preoperative ultrasonographic and MRI findings suggested a benign lesion, thus permitting preservation of the testis.

Testicular epidermoid cysts are benign tumours which account for less than 1% of all testicular tumours. Their uncertain histogenesis, difficult pre-operative diagnosis and controversial therapeutic approach are at the base of this paper. Report on two patients, 20- and 21-year old, with testicular epidermoid cysts treated by inguinal radical orchiectomy and tumorectomy, respectively. Literature review focused on the diagnostic and therapeutic aspects. Emphasis on the relevance of ultrasound for pre-operative diagnosis. We also advocate for a conservative management if their presence is suspected or in the presence of negative tumoral markers.

We report one case of "sex-cord stromal tumor" composed by Leydig and Sertoli cells. An epidermoid cyst of the testicle will be described. Finally, a case of scrotal leiomyoma is reported.

Epidermoid cysts of the testes are rare, benign lesions that account for approximately 1% of all testicular tumors. They present most often between the second and fourth decade of life, and have been reported in prepubertal children rarely. The authors report the clinical and sonographic findings in a 4 1/2-year-old child with a testicular epidermoid cyst, and they analyze the 22 prepubertal cases found in the world literature. As described below, the clinical and sonographic features of this tumor are not specific for an epidermoid cyst and do not preclude a teratomatous or malignant neoplasm. This case adds to the varied sonographic appearance of prepubertal testicular epidermoid cysts. The lack of either unique clinical or sonographic features would suggest that extreme caution be used if local excision is considered for a patient with presumed epidermoid cyst of the testicle.

The epidermoid cyst of the penis is an uncommon benign intratesticular tumour. This paper presents two cases that were diagnosed and operated in our centre. It also describes the most significant clinical, radiological and histological aspects.

Epidermoid cyst of the testis is a rare, benign testicular tumor. It is estimated that epidermoid cyst of the testis represent less than 1% of all testicular tumors. Opinion is divided as to the best treatment for this condition. The majority opinion favours excision of the tumour and preservation of the testis, although some recommend radical inguinal orchiectomy. We present a case of a 26 years old man with an epidermoid cyst of the testis and submitted to organ preserving surgery. Organ preserving surgery with the excision or enucleation of the epidermoid cyst suffices, having not been reported relapse or metastasis after such treatment. The longest reported follow up time is 37 years. The conservative management of epidermoid cyst is an alternative with important psycho logical benefits and without jeopardizing life.

Objective: To present experience in the diagnosis and management of patients with an epidermoid cyst of the testes and to confirm the role of conservative surgery., Patients and Methods: The records from the last 26.5 years of patients diagnosed as having a testicular tumour were reviewed retrospectively. Those patients with a confirmed epidermoid cyst were evaluated for age, clinical assessment, methods of diagnosis, treatment and follow-up., Results: Amongst a total of 131 testicular tumours, 11 patients (8.4%; mean age 25.7 years, range 21-35) were diagnosed pathologically as having an epidermoid cyst. Pre-operative suspicion of the benign nature of the lesions was supported by testicular ultrasonography in six patients and supplemented with magnetic resonance imaging (MRI) in one. An operation sparing the testicles was performed in eight patients after the diagnosis of epidermoid cyst was confirmed from frozen sections. Three patients were treated by radical orchidectomy. There were no relapses after a median follow-up of 47.3 months (range 2-82)., Conclusion: In this series, the relative incidence of epidermoid cyst was higher than that reported in the literature (1-2%). Ultrasonography and MRI of the testes may allow the diagnosis to be made preoperatively. The absence of relapse in these patients further supports the use of organ-sparing surgery in these young men.

We present a case of bilateral testicular epidermoid cysts. These lesions were identified in a 22-year-old male who had previously experienced mild testicular trauma. Management consisted of inguinal exploration and wedge resection on one side and transscrotal exploration and excision on the other. This case represents the second reported case of bilateral conservative management of testicular epidermoid cysts in an adult male. The etiology and management alternatives for testicular epidermoid cysts are discussed.

Our experience with 18 patients with simple epidermoid cysts of the testis (monodermal teratoma) is reported. In all patients the tumor was enucleated completely and 2 biopsies of the adjacent parenchyma were obtained for exclusion of associated germ cell cancer, scar or carcinoma in situ. There was no evidence of malignancy in any biopsy specimen. Preoperative evaluation included physical examination, testicular sonography, and determination of alpha-fetoprotein and beta-human chorionic gonadotropin levels. Although epidermoid cyst was strongly suggested by sonography, the ultrasonic appearance was not specific and inguinal testicular exploration was required. In 1 patient multiple epidermoid cysts of the right testis were associated with an adult teratoma containing embryonal carcinoma and choriocarcinoma of the left testicle. To our knowledge no similar case has been described in the literature. Based on our results and our experience, we consider tumor enucleation and biopsy of the adjacent parenchyma as adequate treatment for the benign epidermoid cyst. The literature concerning organ sparing surgery in testicular epidermoid cysts is reviewed.

Teratoma ranks second in frequency to yolk sac carcinoma among testicular germ cell tumors in infants, accounting for 25% of cases. Testicular teratomas are uniformly benign in children younger than 24 months old. Epidermoid cysts are tumor-like lesions of unknown etiology, probably monodermal teratomas, comprising 3% of all pediatric testis tumors. Bilaterality is rare for both tumors. We report a case of a synchronous left testis teratoma and a right testis epidermoid cyst. Appropriate therapy is discussed.

We report a case of a paratesticular epidermoid cyst with a concurrent dermoid cyst of the ipsilateral spermatic cord at the internal inguinal ring. The patient presented for evaluation of a presumed testicular neoplasm. Epidermoid and dermoid cysts were confirmed histologically after local excision. To our knowledge concomitant occurrence of these lesions has not been reported previously. We discuss the pathogenesis, diagnosis and treatment.