Epidermoid Cyst and Teratoma of the Testis

Abstract

There is considerable overlapping of the sonographic appearances of teratomas and epidermoid cysts of the testis. Although the onion ring appearance of an intratesticular tumor is suggestive of an epidermoid cyst, this appearance may also be found in cases of a teratoma. Whereas the former condition can be treated by local enucleation, the latter requires radical orchiectomy.

The Testis Completely Replaced by a Huge Epidermal Cyst in an Older Man

“…They usually occur in the hair-bearing areas of the body, such as the scalp, face, neck, trunk, and back [ 1 2 3 ]. Epidermal cysts are a rare benign tumor of the testicle, and are usually discovered in the second and fourth decades of life [ 4 ]. We report an unusual testicular mass in an older patient, in whom the testis was found to have been completely replaced with an epidermal cyst.…”

Bilateral Testicular Epidermoid Cysts

“…Alternatively, many cases of TEC show a heterogeneous echotexture with a target or bull's eye pattern consisting of a hyperechoic capsule, hypoechoic content of fat and water, and a hyperechoic central focus representing keratin debris. [8] It is uncommon to see calcifications. [4] Color Doppler examination consistently reveals TEC to be avascular,[312] unlike most testicular malignancies.…”

“…[8] The latter histologic finding removes the tumor from the clearly benign category and necessitates aggressive treatment. In addition, TEC occasionally appears atypical, with a multilocular configuration, without the onion ring or target appearance.…”

“…In addition, TEC occasionally appears atypical, with a multilocular configuration, without the onion ring or target appearance. [8] In a patient with TEC, additional lesions must be sought assiduously because of the possibility of synchronous teratoma. [14] However, the situation is further complicated by the existence of mature teratoma in pre-pubertal boys, which, like TEC, is derived from benign germ cells and, like TEC, is a benign lesion.…”

CASE REPORTS Intratesticular epidermoid cyst: is radiological diagnosis enough?

“…In addition, extensive keratinization inside the cyst makes a characteristic onion skin-like appearance, seen in ultrasound scan and magnetic resonance imaging (MRI) studies, which strongly supports the diagnosis [4]. However, recently it has been shown that mature teratomas might have a similar ultrasonic feature to the epidermoid cysts [5]. Therefore, though a triad of findings including the sonographic appearance of an onion ring, avascularity on Doppler sonography, and negative results of tumor marker studies-is highly suggestive of an epidermoid cyst, due to the above-mentioned it would be unsafe to completely rely on ultrasound [6].…”