Clinical features and surgical outcomes of testicular epidermoid cysts in children.

To investigate the clinical features, surgical outcomes, and prognosis of testicular epidermoid cysts in children, to enhance the understanding of this rare benign lesion, reduce misdiagnosis and overtreatment, optimize clinical decision-making, and improve the quality of life in affected children. A retrospective analysis was conducted on the clinical data of 23 pediatric patients with testicular epidermoid cysts treated at our hospital between September 2015 and April 2024. Data collected included age, laterality, disease duration, AFP levels, tumor size, operative time, intraoperative blood loss, and length of hospital stay. Descriptive statistical analysis was performed. All 23 cases involved unilateral lesions, with 9 on the left and 14 on the right. The mean age was 75.2 ± 43.6 months. The median interval from discovery to consultation was 15 days (interquartile range [IQR]: 7-180 days). The median preoperative AFP level was 1.3 ng/ml (IQR: 0.50-2.5 ng/ml), with only one case showing a significant elevation (22.90 ng/ml). The median maximum diameter of the lesions was 1.0 cm (IQR: 0.8-1.2 cm). All patients underwent testis-sparing tumor enucleation, with a mean operative time of 45.3 ± 13.0 min and a median intraoperative blood loss of 2.0 ml (IQR: 1.0-2.0 ml). The median hospital stay was 3.0 days (IQR: 2.0-3.0 days). All patients recovered well postoperatively, with no recurrence or testicular atrophy observed during follow-up. Testicular epidermoid cysts are rare in children and typically present as painless scrotal masses. Preoperative imaging aids in diagnosis, while intraoperative frozen-section pathology facilitates testis-sparing surgery. Definitive diagnosis depends on postoperative histopathology. Tumor enucleation is minimally invasive, effective, and associated with excellent prognosis, making it the preferred treatment approach for this condition.