Bleve Cosimo, Conighi Maria Luisa, Bucci Valeria, Costa Lorenzo, Chiarenza Salvatore Fabio
Department of Pediatric Surgery and Pediatric Minimally Invasive Surgery and New Technologies, San Bortolo Hospital, Vicenza.
Pediatr Med Chir. 2018 May 29;40(1). doi: 10.4081/pmc.2018.162.
Epididymal cysts (ECs) are relatively common in adults, rare in children. Normally their treatment is conservative. They may be situated anywhere in the organ, frequently in the region of the head. Torsion of these cysts is extremely rare in both children and adults, causing acute scrotal swelling. The diagnosis is intraoperative. A 16-year-old boy was referred to our Divisional Clinic by the treating physician for scrotal swelling appeared 4 months earlier. Absence of a history of minor scrotal trauma. Ultrasonography showed a 40×50 mm fluid-filled right para-testicular mass. We performed surgery finding a large black cyst connected to the head of the epididymis with 720°-degrees rotation. Histology revealed an acquired EC. The particularity of our case is due to the absence of symptoms in association with a big EC twisted of 720° degrees. This is the only case reported in literature. All patients with EC torsion reported presented symptoms related to acute scrotum.
附睾囊肿（ECs）在成年人中相对常见，在儿童中罕见。通常其治疗是保守的。它们可位于附睾的任何部位，常见于头部区域。这些囊肿在儿童和成人中发生扭转都极为罕见，会导致急性阴囊肿胀。诊断需在术中进行。一名16岁男孩由主治医生转至我们的科室诊所，其阴囊肿胀于4个月前出现。无轻微阴囊外伤史。超声检查显示右侧睾丸旁有一个40×50毫米的液性肿块。我们进行手术时发现一个大的黑色囊肿与附睾头部相连，扭转了720°。组织学检查显示为后天性附睾囊肿。我们病例的特殊性在于，一个大的附睾囊肿扭转720°却没有相关症状。这是文献中报道的唯一病例。所有报道的附睾囊肿扭转患者均有与急性阴囊相关的症状。
