Epidermoid cysts of the testis: Diagnosis by ultrasonography and magnetic resonance imaging resulting in organ-preserving surgery

Objective: To present experience in the diagnosis and management of patients with an epidermoid cyst of the testes and to confirm the role of conservative surgery. Patients and methods: The records from the last 26.5 years of patients diagnosed as having a testicular tumour were reviewed retrospectively. Those patients with a confirmed epidermoid cyst were evaluated for age, clinical assessment, methods of diagnosis, treatment and follow-up. Results: Amongst a total of 131 testicular tumours, 11 patients (8.4%; mean age 25.7 years, range 21-35) were diagnosed pathologically as having an epidermold cyst. Pre-operative suspicion of the benign nature of the lesions was supported by testicular ultrasonography in six patients and supplemented with magnetic resonance imaging (MRI) in one. An operation sparing the testicles was performed in eight patients after the diagnosis of epidermoid cyst was confirmed from frozen sections. Three patients were treated by radical orchidectomy. There were no relapses after a median follow-up of 47.3 months (range 2-82). Conclusion: In this series, the relative incidence of epidermoid cyst was higher than that reported in the literature (1-2%). Ultrasonography and MRI of the testes may allow the diagnosis to be made pre-operatively. The absence of relapse in these patients further supports the use of organ-sparing surgery in these young men.