Testicular epidermoid cyst--is pre-operative diagnosis possible?

A case of testicular epidermoid cyst which had initially been misdiagnosed as a malignant testicular tumour is presented. The role of clinical and ultrasound examination in the pre-operative assessment is discussed. Although the benign nature of this condition must be demonstrated histologically before conservative surgery is contemplated, it is equally important that the patient should not be told that the tumour is malignant without adequate evidence.