Maulana Reza, Siregar Safendra, Hernowo Bethy S
Urology Department, Hasan Sadikin Academic Medical Center, Universitas Padjadjaran, Bandung, Indonesia; Urology Department, Universitas Syiah Kuala, Aceh, Indonesia.
Urology Department, Hasan Sadikin Academic Medical Center, Universitas Padjadjaran, Bandung, Indonesia.
Int J Surg Case Rep. 2022 May;94:107167. doi: 10.1016/j.ijscr.2022.107167. Epub 2022 May 4.
Testicular epidermoid cysts (TECs) are rare benign testicular neoplasms. Recently, testicular epidermoid cysts (TECs) are listed as teratoma of prepubertal type, however it is still difficult to differentiate the epidermoid cyst from malign testicular tumor. Therefore, we would like to report testicular epidermoid cyst at our institution.
A 67-year-old man from Indonesia, presented with chronical painless mass of testis since one year ago. On physical examination obtained normal penile structure with descended testicles, palpable intrascrotal mass with size of 10 × 7 × 5 cm, firm consistency, immobile, without any tenderness, and no lymphadenophaty in groin. Scrotal USG showed intratesticular mass, homogenous parenchym, showed no vascularization during Doppler examination. Histopathological examination revealed the specimen of right scrotum with size of 12.5 cm × 8.5 cm × 6.1 cm with red-brownish colored, during lamellation, obtained encapsulated mass with size of 12.2 cm × 7.9 cm × 6 cm, hollowed space filled with porridge-like texture with capsule thickness of 0.1-0.3 cm.
Epidermoid cysts are benign lesions occurring on the skin usually, however, it rarely occurs in intratesticular area. Most of the cases (60%) presented with the typical onion-ring phenomenon. Histopathological findings commonly revealed typical well-defined cyst lined by a fibrous membrane. No skin appendages are found in the cyst's lumen and no germ cell neoplasm (GCN) is present in the adjacent testicular parenchyma.
All testicular masses are considered malignant until proven otherwise. It is necessary to do accurate diagnosis for the prevention of unnecessary radical orchiectomy.
睾丸表皮样囊肿(TECs)是罕见的良性睾丸肿瘤。近来,睾丸表皮样囊肿被列为青春期前型畸胎瘤,但将表皮样囊肿与恶性睾丸肿瘤区分开来仍很困难。因此,我们在此报告我院的睾丸表皮样囊肿病例。
一名来自印度尼西亚的67岁男性,自一年前起出现睾丸慢性无痛性肿块。体格检查显示阴茎结构正常,睾丸已降入阴囊,可触及阴囊内大小为10×7×5厘米的肿块,质地坚硬,固定不动,无压痛,腹股沟无淋巴结肿大。阴囊超声检查显示睾丸内肿块,实质均匀,多普勒检查未见血管形成。组织病理学检查显示右侧阴囊标本大小为12.5厘米×8.5厘米×6.1厘米,呈红棕色,分层时获得一个大小为12.2厘米×7.9厘米×6厘米的包膜肿块,中空腔内充满粥状物质,包膜厚度为0.1 - 0.3厘米。
表皮样囊肿通常是发生在皮肤上的良性病变,然而,它很少发生在睾丸内。大多数病例(60%)呈现典型的洋葱环现象。组织病理学检查结果通常显示典型的边界清晰的囊肿,内衬纤维膜。囊肿腔内未发现皮肤附属器,相邻睾丸实质内也未发现生殖细胞肿瘤(GCN)。
在未证实其他情况之前,所有睾丸肿块均被视为恶性。为避免不必要的根治性睾丸切除术,进行准确诊断很有必要。