Intra-testicular epidermoid cyst: a rare case report with clinico-radiological dilemma

Abstract

Intra-testicular epidermoid cyst of testis is a benign tumour and accounts for 1-2% of all testicular neoplasms. It is a benign lesion, and should be distinguished from dermoid cyst or teratoma, which have a considerable malignant potential. We describe a rare case of testicular epidermoid cyst in an elderly male presenting with gradually increasing testicular mass since 8 months. Local examination revealed a non-tender, irregular, hard mass in the right testis. All routine laboratory investigations along with tumour markers were within normal limits. Ultrasound showed features of a testicular neoplasm following which orchidectomy was performed. Grossly, cut surface of testis showed a cyst measuring 4x2x1cm and microscopic examination revealed features of an epidermoid cyst. Extesive sampling excluded the possibility of a teratomatous focus. This case is described owing to the rarity of this neoplasm and the unusual clinico-radiological presentation. The pre-operative diagnosis of this tumour can be made if characteristic sonographic and MRI findings are obtained in the absence of which these masquerade neoplastic lesions. Histopathological examination thus is vital for a decisive diagnosis.