Torsion of Epididymal Cyst: A Case Report With Review of Literature

Torsion of an epididymal cyst is one of the rare and least-known causes of acute scrotal pain. Epididymal cysts, when large, can undergo occasional complications like infection or, rarely they might undergo torsion, needing emergency surgery. We present a case of a 37-year-old gentleman with acute scrotal pain to the scrotum. Testicular torsion was suspected clinically, but sonography revealed a normal-appearing testis and a large left-sided epididymal cyst with internal echoes and dependent debris. A diagnosis of epididymal cyst torsion was suspected based on sonographic findings. Exploratory surgery showed a reddish, inflamed epididymal cyst that had undergone torsion on its pedicle. The cyst was excised leading to symptomatic relief to the patient. Due to the rarity of this condition, such cases are often misdiagnosed clinically as testicular torsion. Ultrasonography helps in aiding the correct diagnosis and the radiologist needs to be familiar with the radiological aspects of diagnosing torsion of epididymal cysts.