Cystic dysplasia of the testis: an unusual cause of a pediatric scrotal mass.

OBJECTIVES

To describe a case of cystic dysplasia of the testis (CDT), an uncommon cause of scrotal swelling in the pediatric patient. Clinical, radiographic, and pathologic findings are discussed and the 10 previously reported cases are reviewed.

METHODS

A 4-year-old boy presented with asymptomatic scrotal swelling and was found to have a palpable mass in the upper pole of the right testicle with evidence of partial transillumination. A scrotal ultrasound revealed testicular enlargement with multiple cystic changes suggesting teratoma and operative exploration was recommended.

RESULTS

Intraoperative findings included a multicystic mass in the right testicle with minimal normal testicular parenchyma. Subsequent inguinal orchiectomy was performed and pathologic examination revealed a benign, multilobulated configuration of cysts in the region of the rete testis with atrophy of the surrounding testicle. These findings were similar to those found in previously reported cases of CDT. Ipsilateral renal agenesis, a commonly associated anomaly, was also discovered in our patient.

CONCLUSIONS

CDT is a rare cause of the pediatric scrotal mass that requires a high index of suspicion for diagnosis based on well-described clinical and sonographic findings. When feasible, a testicular-sparing approach should be considered and all patients should undergo evaluation for associated urologic anomalies.