Epidermoid cyst. Answer to the e-quid “A testicular mass”

Taupin, T.; Rouvière, Olivier; Cuzin, B.; Mège‐Lechevallier, Florence; Boutier, R.

doi:10.1016/j.diii.2012.04.010

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Testicular epidermoid cysts (ECs) represent a subtype of teratoma of the prepubertal type, included in the group of TGCTs unrelated to GCNIS [ 39 ]. The ability of preoperative imaging to suggest the diagnosis of an EC may prompt a conservative treatment, including TSS, instead of radical orchiectomy [ 8 , 79 , 80 , 81 , 82 , 83 ].…”

Section: Characterization Of Testicular Masses: Benign Versus Malignantmentioning

confidence: 99%

“…Histologically, EC is a squamous epithelium-lined unilocular cystic lesion, composed of concentric layers of laminated keratinous material, which are responsible for its characteristic imaging appearance [ 79 , 80 , 81 , 82 , 83 ]. MRI may provide supportive findings for the diagnosis of EC, and is recommended as a complimentary imaging examination in cases of equivocal US findings [ 14 ].…”

Section: Characterization Of Testicular Masses: Benign Versus Malignantmentioning

confidence: 99%

“…Typically, an EC is an oval encapsulated lesion surrounded by a hypointense halo on both T1WI and T2WI, which does not enhance after the administration of the contrast material. Alternating zones of high and low signal intensity on T2WI (“onion skin sign”), or a hyperintense central area (“target appearance”)—the latter corresponding to the paradox T1 hyperintensity of calcium depositions—are imaging findings suggestive of the diagnosis [ 79 , 80 , 81 , 82 , 83 ].…”

Section: Characterization Of Testicular Masses: Benign Versus Malignantmentioning

confidence: 99%

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An Overview of the Role of Multiparametric MRI in the Investigation of Testicular Tumors

Tsili

Sofikitis

Pappa

et al. 2022

Cancers

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Conventional ultrasonography represents the mainstay of testis imaging. In cases in which ultrasonography is inconclusive, scrotal MRI using a multiparametric protocol may be used as a useful problem-solving tool. MRI of the scrotum is primarily recommended for differentiating between benign and malignant testicular masses when sonographic findings are ambiguous. This technique is also accurate in the preoperative local staging of testicular tumors and, therefore, is recommended in patients scheduled for testis-sparing surgery. In addition, MRI may provide valuable information regarding the histological characterization of testicular germ-cell tumors, in selected cases. Scrotal MRI may also help in the differentiation between testicular germ-cell neoplasms and non-germ-cell neoplasms. Axial T1-weighted imaging, axial and coronal T2-weighted imaging, axial diffusion-weighted imaging, and coronal subtracted dynamic contrast-enhanced imaging are the minimum requirements for scrotal MRI. A variety of MRI techniques—including diffusion tensor imaging, magnetization transfer imaging, proton MR spectroscopy, volumetric apparent diffusion coefficient histogram analysis, and MRI-based radiomics—are being investigated for testicular mass characterization, providing valuable supplementary diagnostic information. In the present review, we aim to discuss clinical indications for scrotal MRI in cases of testicular tumors, along with MRI findings of common testicular malignancies.

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Section: Characterization Of Testicular Masses: Benign Versus Malignantmentioning

confidence: 99%

Section: Characterization Of Testicular Masses: Benign Versus Malignantmentioning

confidence: 99%

Section: Characterization Of Testicular Masses: Benign Versus Malignantmentioning

confidence: 99%

See 1 more Smart Citation

An Overview of the Role of Multiparametric MRI in the Investigation of Testicular Tumors

Tsili

Sofikitis

Pappa

et al. 2022

Cancers

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“…However, it is still di cult to differentiate epidermoid cysts from malignant testicular tumors on imaging [18]. The conventional ultrasound appearance of a typical epidermoid cyst is an "onion skin-like" echo [19] with a well-de ned circular non-homogeneous echo with no blood ow signals on CDFI. In this study, only one case was diagnosed with an epidermoid cyst due to an "onion skin-like" echo (no blood ow signal was seen).…”

Section: Testicular Non-neoplastic Lesionsmentioning

confidence: 99%

The value of contrast-enhanced ultrasonography in the diagnosis of primary testicular non-neoplastic and neoplastic lesions in adults

Xue

Zhang

Wang

2022

Preprint

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Background: Different pathological types of testicular tumors are treated differently. For example, malignant germ cell tumors require radical orchiectomy, benign tumors only require mass enucleation and segmental infarction does not require treatment. Contrast-enhanced ultrasonography (CEUS) can more sensitively display tumor microvessels, thereby distinguishing between benign and malignant tumors.Methods: This was a retrospective analysis of 35 patients with primary testicular non-neoplastic and neoplastic confirmed by pathology in our hospital from February 2017 to February 2022. Conventional ultrasonography and CEUS of primary testicular non-neoplastic lesions and neoplastic lesions of different pathological types in adults were retrospectively analyzed and their diagnostic values were compared with the pathological results. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates for conventional ultrasound in the diagnosis of benign testicular tumors based on "onion skin-like" echo (epidermoid cysts) and peripheral annular blood flow were 30.8%, 100.0%, 100.0%, 71.9% and 75.0%, respectively. According to CEUS without enhancement (non-neoplastic lesions and epidermoid cysts) and uniform high enhancement with fast forward and slow backward (SLCT), the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates for diagnosing benign testicular tumors were 100.0%, 100.0%, 100.0%, 100.0% and 100.0%, respectively. Compared with conventional ultrasound, the difference was statistically significant (P=0.004).Conclusions: CEUS could accurately distinguish between benign and malignant testicular tumors and also diagnosed specific pathological types (such as testicular focal infarction, epidermoid cysts, spermatocytic tumors, SLTC and lymphoma). Different pathological types of testicular tumors had different treatment options; thus, accurate preoperative diagnosis was of great significance and could guide the selection of appropriate treatment options.

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