Epidermoid cyst of the testis: a critical analysis

Our experience with 163 patients (11 from our institution) with simple epidermoid cyst of the testis was analysed. The lesion is nearly as common as interstitial cell tumour of the testis. In its simple form it is a benign lesion that usually appears as a solitary, asymptomatic, testicular, 2-cm mass in non-black young men (usually 20 to 40 years of age). It has been suspected on circumstantial clinical evidence in a few patients (17.5%) who have been successfully treated by simple enucleation. In the majority, however, fear of looking for a zebra in a herd of horses or not thinking of zebras at all has led to radical orchiectomy. None of the 80 patients followed up for a maximum of 37 years has suffered any ill effects.