Tubular ectasia of the rete testis (TERT). Differential diagnosis of cystic testicular disorders

Mahlknecht, Alois; Mahlknecht, Peter; Fallaha, Mohamad; Wieser, Anton

doi:10.4081/aiua.2015.1.5

Cited by 9 publications

(21 citation statements)

References 13 publications

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“…On the other hand, features suspicious for malignant lesions such as palpable testicular masses, cystic lesions associated with a solid mass, and presentation at a younger age, prompt further workup [2][3][4][5]. Magnetic resonance imaging is used when in doubt, due to its precise tissue differentiation, which helps in confirming or excluding other differentials [1]. On T1 and proton-density-weighted images, tubular ectasia of the rete testis demonstrates homogenous signal intensity lower than that of the testis.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, they show no signs of blood flow on Doppler scan. TERT is bilateral in almost one-third of all cases and most have associated epididymal pathologies such as epididymitis and epididymal cysts [1][2][3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…Benign conditions include cystic dysplasia, testicular epidermoid cysts, simple testicular cysts, tunica albuginea cysts, and intra-testicular varicoceles. Malignant conditions which mimic TERT on imaging mainly include mature cystic teratomas, papillary adenocarcinomas of the rete testis, and metastatic tumors within the ducts of the epididymis (Table 2) [1,[8][9][10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…Simple Testicular Cyst [1,11] Solitary cyst appear on ultrasonography as round anechoic lesion with a surrounding echoic margin, its size ranges between 0.2-2.0 cm.…”

Section: Benign Conditionsmentioning

confidence: 99%

“…Cystic Dysplasia [1,8,9] A condition suspected to be of congenital etiology due to its frequent presentation in children and association with genitourinary anomalies. Ultrasound demonstrates numerous anechoic lesions located centrally at the mediastinum testis.…”

Section: Benign Conditionsmentioning

confidence: 99%

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Bilateral Ductal Ectasia of the Rete Testis: A Case Report and Literature Review

Omer¹,

Engelman²,

Krauthamer³

et al. 2017

Reprod Syst Sex Disord

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A 58-year-old male presented to the emergency department with right scrotal pain and swelling. The patient's past medical history of epididymitis was unraveled. A multiplanar grayscale sonogram with Doppler scan of the scrotum and intra-testicular arterial pulse waveform was performed which demonstrated features of tubular ectasia of the rete testis. There was increased flow at the epididymal head which prompted the possibility of an inflammatory process consequently antibiotic therapy was administered. Tubular ectasia of the rete testis is a benign condition usually found incidentally, it has a prevalence of 1.64% in the population. This condition can be associated with a history of trauma, surgery, and inflammatory or infectious conditions. In case there is a suspicion of malignant etiology, magnetic resonance imaging (MRI) is used for better tissue differentiation. Keywords: Scrotal pain; Doppler scan; Epididymal head; Testes Case ReportA 58-year-old male presented to the emergency department with right scrotal pain and swelling. The pain was severe, gradually progressive, radiated to the groin, and worsened with touch and movement. There was associated bilateral scrotal swelling and dysuria without fever, rash, or penile discharge. Our patient reported recurrent similar but less severe symptoms, as well as a history of epididymitis two years before presentation. A multiplanar grayscale ultrasound with color Doppler of the scrotum and intra-testicular arterial pulse wave was performed, which demonstrated normal homogenous echotexture bilaterally with no evidence of intra-testicular masses. Both testes demonstrated grossly symmetric color Doppler flow with normal intra-testicular arterial waveforms. A small anechoic left epididymal head cyst without evidence of a hydrocele was visualized (Figures 1 and 2). There were right and left tubular anechoic lesions located at the mediastinum testis, more prominent on the right, consistent with tubular ectasia of the rete testes. The right epididymal head demonstrated asymmetric increased color Doppler flow compared to the left, consistent with an inflammatory or infectious process.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Simple Testicular Cyst [1,11] Solitary cyst appear on ultrasonography as round anechoic lesion with a surrounding echoic margin, its size ranges between 0.2-2.0 cm.…”

Section: Benign Conditionsmentioning

confidence: 99%

Section: Benign Conditionsmentioning

confidence: 99%

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Bilateral Ductal Ectasia of the Rete Testis: A Case Report and Literature Review

Omer¹,

Engelman²,

Krauthamer³

et al. 2017

Reprod Syst Sex Disord

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Dysregulation of Notch-FGF signaling axis in germ cells results in cystic dilation of the rete testis in mice

Cao

Liu

Lin

et al. 2021

J. Cell Commun. Signal.

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Numb (Nb) and Numb-like (Nbl) are functionally redundant adaptor proteins that critically regulate cell fate and morphogenesis in a variety of organs. We selectively deleted Nb and Nbl in testicular germ cells by breeding Nb/Nbl floxed mice with a transgenic mouse line Tex101-Cre. The mutant mice developed unilateral or bilateral cystic dilation in the rete testis (RT). Dye trace indicated partial blockages in the testicular hilum. Morphological and immunohistochemical evaluations revealed that the lining epithelium of the cysts possessed similar characteristics of RT epithelium, suggesting that the cyst originated from dilation of the RT lumen. Spermatogenesis and the efferent ducts were unaffected. In comparisons of isolated germ cells from mutants to control mice, the Notch activity considerably increased and the expression of Notch target gene Hey1 significantly elevated. Further studies identified that germ cell Fgf4 expression negatively correlated the Notch activity and demonstrated that blockade of FGF receptors mediated FGF4 signaling induced enlargement of the RT lumen in vitro. The crucial role of the FGF4 signaling in modulation of RT development was verified by the selective germ cell Fgf4 ablation, which displayed a phenotype similar to that of germ cell Nb/Nbl null mutant males. These findings indicate that aberrant over-activation of the Notch signaling in germ cells due to Nb/Nbl abrogation impairs the RT development, which is through the suppressing germ cell Fgf4 expression. The present study uncovers the presence of a lumicrine signal pathway in which secreted/diffusible protein FGF4 produced by germ cells is essential for normal RT development.

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Spontaneous regression of cystic dysplasia of the rete testis in an 18-month-old boy: the key role of ultrasonography

et al. 2019

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Cystic dysplasia of the rete testis (CDT) is a rare cause of scrotal swelling in children. It is a congenital disorder and it can be associated with other genitourinary abnormalities. At present, there is no clear consensus on treatment. Surgical approach has traditionally been the treatment of choice, while, more recently, conservative approach has been applied, justified by the benign nature of the lesion and after few cases of spontaneous regression have been documented. Ultrasonography, supported by negative tumor markers, plays a key role in the diagnostic work up and during observational follow-up. We report a further case of spontaneous regression of suspected CDT in an 18-month-old boy, who has been followed with clinic and ultrasonographic checks.

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Tubular ectasia of the rete testis (TERT). Differential diagnosis of cystic testicular disorders

Cited by 9 publications

References 13 publications

Bilateral Ductal Ectasia of the Rete Testis: A Case Report and Literature Review

Bilateral Ductal Ectasia of the Rete Testis: A Case Report and Literature Review

Dysregulation of Notch-FGF signaling axis in germ cells results in cystic dilation of the rete testis in mice

Spontaneous regression of cystic dysplasia of the rete testis in an 18-month-old boy: the key role of ultrasonography

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