Intrascrotal extratesticular epidermoid cyst

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Epidermoid cysts represent a rare subset of testicular tumors, accounting for approximately 1% of all neoplasms affecting the testicles.
• While typically intratesticular, epidermoid cysts can exceptionally occur as intrascrotal but extratesticular masses.

Observation:

• This report details a unique case of an intrascrotal extratesticular cyst.
• Diagnostic imaging revealed a characteristic "onion ring" sonographic appearance.
• Doppler sonography demonstrated avascularity of the lesion.

Findings:

• The combination of the onion ring sign, lack of vascularity on Doppler, and negative tumor markers strongly suggests an epidermoid cyst.
• These findings are highly indicative of a benign epidermoid cyst, differentiating it from malignant testicular tumors.

Implications:

• Recognizing this specific sonographic pattern aids in the accurate preoperative diagnosis of extratesticular epidermoid cysts.
• This case underscores the importance of integrating imaging findings with clinical and laboratory data for precise diagnosis.
• Early and accurate diagnosis can prevent unnecessary orchiectomy and guide appropriate management strategies for patients.