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Anterior mediastinal teratomas are common and are generally characterized as slow growing tumors. Very few reports documenting rapidly growing tumors exist. Here, we describe a case of a mature teratoma showing rapid growth in 1 year treated with complete surgical resection., Highlights • A 25-year-old man was diagnosed with teratoma in the anterior mediastinum. • Additionally, he had testicular epidermoid cyst and familial Mediterranean fever. • Both tumors were surgically resected. • The postoperative course was uneventful with no evidence of recurrence.

Epidermoid cysts are rare. They represent the most common benign tumor of the testis. The sonographic appearances of testicular epidermoid cysts usually include avascular, mostly lamellated, heterogeneous internal echotexture, with hypoechoic and hyperechoic concentric rings, accounting for the typical onion-ring appearance. On MRI, epidermoid cysts show a low-signal-intensity center, with internal concentric rings of alternating high- and low-signal intensity on T2-weighted images, which correlates with the onion-ring appearance. We report a patient with testicular epidermoid cyst with atypical ultrasound and MRI appearances that led to the erroneous initial diagnosis of "burned-out" tumor. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:448-451, 2016.

Intratesticular epidermoid cyst is a rare benign lesion of testis. It is important to distinguish this benign lesion from malignant testicular tumor . This is a case report of a 18yr old patient who presented with a mass in the left testis. His ultrasound showed typical onion skin appearance and tumour markers were within normal limits. Subsequently FNAC was performed which showed anucleated clumps of squamous epithelial cells admixed with the native testicular cells, thus diagnosis of testicular epidermoid cyst was made. Cytology along with sonographic findings provide rapid diagnosis and patient can be relieved of unnecessary anxiety. DOI: 10.21276/APALM.1152

Testicular epidermoid cysts are a rare cause of testicular pathology. No cases of recurrence or metastasis have been reported in the literature. As a result, inguinal partial orchiectomy with frozen section has recently become standard treatment. A 43-year-old male presented with right testicular discomfort and the presence of mass. Right inguinal partial orchiectomy with frozen section was performed, and the right testicle was preserved. The final pathology report confirmed the diagnosis of an epidermoid cyst. The importance of accurate diagnosis of this benign lesion is crucial for the prevention of unnecessary radical orchiectomy.

Introduction: Typical testicular epidermoid cysts (TECs) manifestate as a target sign or onion skin sign on ultrasonography and magnetic resonance (MR) imaging. Clinicians are increasingly aware of the imaging characteristics of typical TECs, which allow accurate diagnosis and successful treatment while preserving the testicle, but atypical TECs are likely to be misdiagnosed as a malignant intratesticular neoplasm, leading to complete testicular resection. Patient concerns: A 26 year-old male patient complained of a painless enlargement of the left testicle that had been present for 1 month. The patient had no recent medical history of scrotal trauma or systemic infection. Diagnosis: A round 48 mm × 45 mm × 43 mm mass was seen inside the left testicle. T2-weighted images of the lesion showed a thin hypointense capsule. T1-weighted images of the lesion showed a hyperintense nodule on the cyst wall, which appeared hypointense on T2-weighted and SPAIR images. After Gd-DTPA injection, the lesion was not enhanced; however, the nodule was enhanced on THRIVE images. These manifestations were consistent with a benign intratesticular lesion, and MR imaging diagnosed atypical TEC, which was confirmed by pathology after surgery. Interventions: The patient was treated with organ-sparing surgery with testicular enucleation. Outcomes: The patient was re-examined with ultrasonography 3 months after surgery. The left residual testicular tissue appeared normal, and reproductive function was preserved. Conclusion: Urologists must be aware of the clinical and MR imaging characteristics of atypical TECs and the utility of preoperative MR imaging for the diagnosis of testicular lesions to ensure that organ-sparing surgery is performed rather than unnecessary orchiectomy.

Testiküler epidermoid kist benign, non-teratomatöz bir tümördür. Hastalar tipik olarak ağrısız ve hassas olmayan testiküler kitle ile başvururlar. Preoperatif ultrasonografi, normal biyokimyasal tümör belirteçleri ile birlikte başlıca tanı prosedürüdür. Kesin tanı histopatolojiktir. Bu olgu sunumunda inguinal orşiektomiye giden 27 yaşındaki bir epidermoid kist hastasının sonografik ve histopatolojik bulgularını sunduk., Testicular epidermoid cyst is a benign, non-teratomatous tumour. Patients typically present with a painless and non-tender, testicular mass. Preoperative ultrasound is major diagnostic procedure combining with normal biochemical tumour markers. The certain diagnosis is histopathological. We present the sonographic and histopathological findings of a 27-year-old male patient with epidermoid cyst who underwent inguinal orchiectomy in this case report.

The low incidence of testicular epidermoid cyst (1-2% of all testicular tumors), makes ultrasound findings the key to making, or at least suggesting, a precise preoperative diagnosis, thus making a conservative treatment possible.We present two cases with ultrasound diagnosis of epidermoid cyst, confirmed later after surgery. We review the literature, emphasizing the evaluation of the ultrasound images and their correlation with the anatomopathological findings.Keywords: Testicular epidermoid cyst, Testicular tumor, Ultrasound. Resumen: La escasa incidencia del quiste epidermoide de testiculo (1-2% de todos los tumores testicu-lares), hace de los hallazgos ecograficos la clave para realizar o al menos sugerir un diagnostico prequi-rurgico preciso, haciendo por tanto posible un tratamiento conservador.Presentamos dos casos con diagnostico ecografico de quiste epidermoide, confirmado posteriormente tras cirugia. Realizamos una revision de la bibliografia, enfatizando en la valoracion de las imagenes ecograficas y su correlacion con los hallazgos anatomopatologicos.Palabras clave: Ecografia, Quiste epidermoide testicular, Tumor testicular.

Introducción: La gran mayoría de las tumoraciones testiculares son de origen neoplásico, lo que determina habitualmente una cirugía radical. Los quistes epidermoides testiculares son una entidad benigna rara, que plantea dificultades en su diagnóstico clínico. Material y métodos: Se realizó una revisión de los tumores testiculares, encontrando 7 casos de quistes epidermoides. Dentro de la valoración preoperatoria se realizó ecografía escrotal y resonancia magnética en 6 y en 4 pacientes, respectivamente. En 4 casos se realizó también biopsia intraoperatoria. Resultados: Se encontró una imagen típica ecográfica en más del 80 y en el 50% de las resonancias. En las biopsias intraoperatorias realizadas se encontró un 100% de coincidencia con el diagnóstico definitivo de la pieza. Se tomó una conducta conservadora (orquiectomía parcial o tumorectomía) en 6 de los 7 casos (85%), con buena evolución. Conclusión: En los pacientes en que se tiene alta sospecha ecográfica de quiste epidermoide, las características macroscópicas típicas (tumor encapsulado, pequeño tamaño, amarillo nacarado y de fácil enucleación) y un examen con cortes por congelación en el intraoperatorio que confirme el diagnóstico permiten realizar una cirugía conservadora. 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.

Testicular epidermoid cyst is extremely rare injury, which in recent studies has been regarded as a tumor. Some authors consider this lesion as a cystic monodermal teratoma, the histogenesis remains controversial. In this study we provide clinical and morphological characteristics of an epidermoid cyst in the left testicle in a 16 years old patient, where apparently a nodular lesion in the left testicle was detected. Keywords Cyst; Epidermoid; Intratesticular

Figure 1 a. Longitudinal US image of the right testis show a bilobulated mass in the upper medial aspect of the testis. The mass had sharp margins, composed of a central echogenic area and of alternating hyperechogenic and hypoechogenic rings in the periphery (onionskin sign), measuring 2.4 x 1.7 x 1.7 cm. b. Longitudinal Doppler-US image of the right testis demonstrates the absence of vascularization of the mass. Ultrasound (US) revealed a solid mass in the upper pole of the right testis that was well circumscribed, avascular, and displayed the onionskin appearance suggestive of testicular epidermoid cyst (1,2) (Figure-1). Magnetic resonance (MR) confirmed the well-circumscribed intra-testicular mass with a

A case of testicular epidermoid cyst, demonstrating multiple characteristic sonographic patterns in a single lesion, is presented with a brief review of the distinctive ultrasound features. It is important to remember that the sonographic patterns describing testicular epidermoids represent the varied amounts and arrangements of keratin of a particular lesion. A given lesion may demonstrate subtle variability or more than one characteristic pattern at any given time. With this in mind, preoperative characterization of testicular epidermoids should allow for increasing utilization of testicular sparring surgery in the management of this benign lesion.

PubMed ID: 25659561, 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.

Epidermoidzysten sind seltene gutartige Tumoren des Hodens, seltener des inguinalen Samenstrangs. Meist manifestieren sie sich zwischen dem 10. und 39. Lebensjahr. Das Vorkommen bei Neugeborenen ist eine Raritat. Wir berichten uber ein Neugeborenes mit einer Epidermoidzyste des rechten Hodens, welche bereits intrauterin als skrotale Raumforderung aufgefallen war und organerhaltend operiert werden konnte.

This is a case report of a 71-year-old man who presented with an incidental finding of a mass in a solitary right testis. A scrotal ultrasound scan showed the typical features of a testicular epidermoid cyst. Tumour markers were not elevated and the patient was managed non-operatively. On reviewing the literature, we found no previous report on the non-operative management of testicular epidermoid cysts

A case of an epidermoid cyst with an atypical sonographic appearance is presented. Although ultrasound may aid in the diagnosis of this entity, it is not definitive.

Testicular epidermoid cysts are the most common benign tumors of the testes, but account for only 1-2% of all testicular tumors. In a young man presenting with a testicular mass, a high index of suspicion must be maintained for the malignant testicular germ cell tumor, which is 50-times more common than testicular epidermoid cyst. Bilateral testicular epidermoid cysts are a very rare condition, with only a few reports in the literature. It is extremely important in this condition to make a correct pre-operative diagnosis on imaging to enable a testis-sparing surgery.

Epidermoid cysts account for approximately 1% to 2% of all resected testicular masses. These are benign lesions without malignant potential, and conservative management with enucleation is generally preferred over orchiectomy. No cases of local recurrence or metastases have been reported. We report a case of enucleation of an epidermoid cyst with subsequent development of a seminoma in the same testis 5 years later.

We describe the case of a 13-year-old boy with testicular epidermoid cyst who presented with a painless testicular mass. Epidermoid cyst of the testis is a benign, non-teratomatous tumor. It is often possible to make the diagnosis preoperatively, combining typical sonographic features with normal biochemical tumor markers. Preoperative diagnosis will allow for testis-sparing surgery and prevent unnecessary orchiectomy.

Epidermoid cyst is a rare and non-teratomatous, benign tumour of the testis. Testis-sparing surgery is recommended as surgical treatment. We present a 9-year-old-boy with testicular epidermoid cyst. The embryology, histogenesis and treatment of epidermoid cyst of testis, are discussed.

A 28-year-old man was referred to Gunma University Hospital for his hard nodule in his left testis. Ultrasonography showed hyperechoic mass with irregular margin. Serum tumor marker levels were within normal limit. Calcified element of mature teratoma or burned-out tumor was suspected. Left inguinal orchiectomy specimen showed epidermoid cyst of the testis with calcified capsule. We reported this case with some discussion on the treatment of epidermoid cyst of the testis.

A case of testicular epidermoid cyst which had initially been misdiagnosed as a malignant testicular tumour is presented. The role of clinical and ultrasound examination in the pre-operative assessment is discussed. Although the benign nature of this condition must be demonstrated histologically before conservative surgery is contemplated, it is equally important that the patient should not be told that the tumour is malignant without adequate evidence.

Hormonal studies were performed in patients of Klinefelter's syndrome with and without testicular epidermoid cyst. Mean levels of plasma gonadotropins were elevated above normal ranges. The mean testosterone level in plasma was abnormally low. The mean prolactin level in plasma was within the normal limit. However, mean plasma levels of these hormones were not significantly different between the two groups. The administration of LH-RH resulted in low response of plasma gonadotropins. The response of plasma testosterone to the administration of hCG was also abnormally low. However, in the LH-RH and hCG tests there were no significant differences between the two groups. These data suggested that the hormonal disturbance in Klinefelter's syndrome is unrelated to the occurrence of testicular epidermoid cyst.