Epidermoid cyst of the testis

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Epidermoid cyst of the testis is a rare benign lesion of the testis. It is important to differentiate it from a testicular teratoma.

Epidermoid cyst of the testis
Diagnosis in short

Epidermoid cyst of testis. H&E stain. (WC)

LM unilocular cyst lined by squamous epithelium without significant nuclear atypia, no GCNIS (ITGCN)
LM DDx teratoma, mixed germ cell tumour, immature teratoma, dermoid cyst of testis (subtype of teratoma)
Gross unilocular cyst containing keratineous material with a laminated appearance
Grossing notes orchiectomy grossing
Site testis

Signs testicular mass
Symptoms typically asymptomatic
Prevalence rare (1-2% of testicular masses)
Blood work normal (beta-hCG, AFP, LDH)
Prognosis benign
Clin. DDx other testicular mass - germ cell tumours, abscess
Treatment excision to exclude a malignant tumour/treat symptoms

General

  • Rare.
  • Benign.
  • 1-2% of testicular tumours.[1]
  • Typical age: teens to thirties (range: 3-77).[1]

Clinical:

  • Asymptomatic mass (typical).[1]

Gross

Features:[2]

  • Unilocular cyst containing keratineous material with a laminated appearance.

Notes:

  • Teratomas are usually multilocular.
  • Presence of hair suggests a dermoid cyst.

Microscopic

Features:[2]

Notes:

  • Surround testis usually within normal limits.
  • Granulomas may be seen in the context of cyst rupture.

DDx:

Images

See also

References

  1. 1.0 1.1 1.2 Loya, AG.; Said, JW.; Grant, EG. (Oct 2004). "Epidermoid cyst of the testis: radiologic-pathologic correlation.". Radiographics 24 Suppl 1: S243-6. doi:10.1148/rg.24si035223. PMID 15486244.
  2. 2.0 2.1 Ye, H.; Ulbright, TM. (Apr 2012). "Difficult differential diagnoses in testicular pathology.". Arch Pathol Lab Med 136 (4): 435-46. doi:10.5858/arpa.2011-0475-RA. PMID 22458906.