Epidermoid cyst of testis: a case for orchiectomy

Epidermoid cyst of the testis is a benign lesion without report of metastasis. It cannot be differentiated reliably from the far more common malignant testicular mass on a clinical basis. Simple excision of the cyst, even with concurrent biopsy of the apparently normal surrounding parenchyma, does not exclude the possibility of a remote scar or focus of viable tumor. The existence of a concurrent malignant lesion along with an epidermoid cyst may be more than coincidental. For such an undetected associated lesion, appropriate highly successful adjunctive therapy is delayed if excision of the epidermoid cyst alone is performed. Consequently, inguinal orchiectomy should be the treatment of choice for epidermoid cyst of the testis with the subsequent burden of proof placed on the pathologist to exclude associated lesions that may alter therapy.