Slawin Jeremy, Slawin Kevin
Baylor College of Medicine, Texas Medical Center, Houston, TX and Rice University, Houston, TX.
Vanguard Urologic Institute at Memorial Hermann Medical Group, Houston, TX, Baylor College of Medicine, Texas Medical Center, Houston, TX, and Memorial Hermann Hospital, Texas Medical Center, Houston, TX.
Rev Urol. 2014;16(4):198-201.
Epidermoid cysts are benign tumors that comprise approximately 1% of all testicular masses. They usually present as painless masses that can be identified on scrotal ultrasound as well-demarcated intratesticular lesions with mixed echogenicity. This case report describes a rare presentation of an extremely large intratesticular epidermoid cyst with clinical and radiologic findings more consistent with testicular torsion. The sizeable cyst obliterated the surrounding testicular parenchyma, causing it to appear on scrotal Doppler ultrasound as a testicle devoid of blood flow. This obliteration also resulted in failure to identify a testicular mass on physical examination or imaging. The current literature contains previous reports of extratesticular epidermoid cysts presenting as torsion; however, this is the first report of an intratesticular epidermoid cyst presenting in this manner. Though smaller cysts may be managed effectively with testicular-sparing surgery, optimal management of a cyst this size requires orchiectomy.
表皮样囊肿是良性肿瘤，约占所有睾丸肿块的1%。它们通常表现为无痛性肿块，在阴囊超声检查中可被识别为界限清楚的睾丸内混合回声病变。本病例报告描述了一例罕见的巨大睾丸内表皮样囊肿，其临床和影像学表现更符合睾丸扭转。巨大囊肿使周围的睾丸实质消失，导致在阴囊多普勒超声检查中显示为无血流的睾丸。这种消失还导致在体格检查或影像学检查中未能发现睾丸肿块。目前的文献中有关于睾丸外表皮样囊肿表现为扭转的既往报道；然而，这是首例以这种方式表现的睾丸内表皮样囊肿。虽然较小的囊肿可通过保留睾丸的手术有效治疗，但如此大小的囊肿的最佳治疗方法是睾丸切除术。
