Complex tunica albuginea cyst simulating an intratesticular lesion

Cysts of the tunica albuginea are uncommon lesions of the testis which in all reported cases have been benign. Complex cysts of the tunica albuginea can mimic intratesticular lesions, thus necessitating orchiectomy. We present a case of a complex tunica albuginea cyst which mimicked an intratesticular lesion at sonography, as well as at magnetic resonance imaging (MRI). Tangential views, however, suggested that this was in fact an extratesticular lesion. The use of tangential views, as well as knowledge of the appearance of the tunica albuginea at MRI, are important to make this differentiation in order to guide the management of these lesions. To our knowledge, this is the first case in which the appearance of a tunica albuginea cyst at MRI has been described.