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Testicular epidermoid cysts in children: sonographic characteristics with pathological correlation
Claudia Martinez Rios Arellano1, Harry P W Kozakewich, David Diamond
1Department of Radiology, Children's Hospital Boston, 300 Longwood Ave., Boston, MA 02115, USA.
Insights
Testicular epidermoid cysts in children often show target or onion ring patterns on ultrasound. New findings include simple cyst appearances and daughter lesions, aiding diagnosis in pediatric patients.
Area of Science:
- Pediatric Radiology
- Oncology
- Uropathology
Background:
- Testicular epidermoid cyst is a rare benign tumor in children.
- Limited literature exists on pediatric pathological and radiological findings.
- Understanding sonographic features can influence surgical management.
Purpose of the Study:
- To detail the ultrasound (US) characteristics of testicular epidermoid cysts in pediatric patients.
- To correlate these US findings with histopathological results.
Main Methods:
- Retrospective review of 11 pediatric patients with pathologically confirmed epidermoid cysts and preoperative ultrasounds.
- Analysis of medical records, preoperative US images, and pathological specimens.
Main Results:
- Nine of eleven cysts exhibited characteristic target or onion ring appearances.
- One young patient presented with a simple cyst-like lesion.
- Over 80% of cysts displayed peripheral daughter cysts; one cyst had a heterogeneous appearance.
Conclusions:
- Commonly described target and onion ring appearances are key findings.
- Simple cyst and daughter lesion presentations are newly identified features in pediatric epidermoid cysts.
- These sonographic findings aid in diagnosing this benign entity in children.
Background:
Testicular epidermoid cyst is a rare benign tumor in children. Although this entity is widely described in adults in literature, there are no large series describing the pathological and radiological findings in children. Knowledge of the sonographic features seen in children may alter surgical treatment.
Objective:
To describe the specific US characteristics of testicular epidermoid cyst in children and to correlate these findings with pathology.
Materials And Methods:
All children with pathologically proven epidermoid cyst and preoperative sonograms diagnosed at a single children's hospital between 1978 and 2008 were included. For each child, the medical records, preoperative US and pathological specimens were reviewed and correlated.
Results:
Eleven patients (ages 1-17 years old) met our criteria. Nine cysts had characteristic target or onion ring appearances, the youngest patient had a simple cyst-like lesion, one cyst had a heterogeneous appearance, and more than 80% of the cysts presented daughter cysts attached along the periphery of the main cyst.
Conclusion:
In addition to the commonly described findings of the epidermoid cyst (the target and onion ring appearances), simple cysts and the presence of daughter lesions are newly described findings that point to the diagnosis of this benign entity in children.
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