Nasrallah Oussama G, El Mir Mohammad W, Fawaz Mohammad W, Mahdi Jana H, Khouzami Riad A, Bachir Bassel G
Division of Urology, Department of Surgery, American University of Beirut Medical Center.
Faculty of Medicine, American University of Beirut.
Ann Med Surg (Lond). 2024 Sep 10;86(10):6326-6329. doi: 10.1097/MS9.0000000000002565. eCollection 2024 Oct.
Rete testis dysplasia is a cystic anomaly arising from the rete testis presenting normally in the pediatric population. These cases usually regress spontaneously without the need for surgical intervention. There are rare, reported cases of rete testis dysplasia in adulthood, which have been managed surgically.
A 58-year-old man presented with lower urinary tracts symptoms and found to have a slightly larger right testicle namely in the lower pole near the epididymis. Investigation was done using ultrasound of the testicles with Doppler showing an 8 mm cyst contained in 16.5×12.1 mm cystic dysplasia near the rete testis. MRI of the testicles revealed a small intratesticular cyst with adjacent band-like signals, in keeping with rete testis dysplasia. This patient was placed under surveillance and the rete testis dysplasia is stable after 6 months and will not be operated on unless progression on ultrasound is encountered.
The management of cystic dysplasia of the rete testis has been evolving with time. While there have never been clear-cut guidelines on the treatment of this condition, a radical orchiectomy of the affected testicle had traditionally been the preferred treatment option. There have only been three case reports of cystic dysplasia of the rete testis in adults, none of which are known to have been managed by observation.
In conclusion, the authors report a unique case of rete testis dysplasia being managed conservatively showing the benign features of such a pathology, which may be actively surveyed through sequential imaging.
睾丸网发育异常是一种源于睾丸网的囊性异常，在儿科人群中较为常见。这些病例通常会自发消退，无需手术干预。成年期睾丸网发育异常的报道病例罕见，通常采用手术治疗。
一名58岁男性因下尿路症状就诊，发现右侧睾丸稍大，位于附睾附近的下极。通过睾丸超声检查及多普勒检查发现，睾丸网附近有一个16.5×12.1毫米的囊性发育异常，其中包含一个8毫米的囊肿。睾丸MRI显示睾丸内有一个小囊肿，伴有相邻的带状信号，符合睾丸网发育异常。该患者接受了监测，6个月后睾丸网发育异常情况稳定，除非超声检查发现病情进展，否则不会进行手术。
睾丸网囊性发育异常的治疗方法随着时间不断演变。虽然对于这种疾病的治疗从未有过明确的指导方针，但传统上首选的治疗方法是对受影响的睾丸进行根治性睾丸切除术。成年期睾丸网囊性发育异常仅有3例病例报告，均未采用观察治疗。
总之，作者报告了一例独特的睾丸网发育异常保守治疗病例，显示了这种病理的良性特征，可通过连续成像进行积极监测。
