Large Epididymal Cyst: A Tale of Three Testes

  • Authors

    • Tanmay Arora ABVIMS and Dr. RML Hospital
    • Kewecho Akami Department of General Surgery, ABVIMS and Dr. RML Hospital New Delhi
    • Neeti Kapur Department of General Surgery, ABVIMS and Dr. RML Hospital New Delhi
    • Sameer Nain Department of General Surgery, ABVIMS and Dr. RML Hospital New Delhi
    2024-06-18
    https://doi.org/10.14419/7fc6b721
  • Epididymal Cyst; Scrotal Abnormalities; Benign Cystic.

  • Abstract

    Background: An epididymal cyst is a benign cystic structure that develops from the epididymis, typically due to a blockage in the epididymis, resulting in fluid accumulation. These cysts are generally harmless and noncancerous.

    Case Presentation: We examine the case of a 30-year-old male referred by the Psychiatry department for an assessment of the inguinal scrotal region, due to his belief that he had three testicles. Physical examination revealed an extratesticular, fluctuant, and cystic swelling easily palpable and distinct from the body of the left testis. Ultrasound findings showed a 2.3 x 1.7 cm fluid-filled lesion at the head of the epididymis.

    Intervention: Following a psychiatric evaluation, the patient underwent surgical excision of the cyst.

    Conclusion: The histopathological examination of the surgically removed cyst confirmed the diagnosis of an epididymal cyst, underscoring the importance of considering such benign conditions in differential diagnoses of scrotal abnormalities.

  • References

    1. Mukendi, A.M., Bilateral epididymal cyst with spontaneous resolution. Clin Case Rep, 2020. 8(12): p. 2689-2691. https://doi.org/10.1002/ccr3.3199.
    2. Valentino, M., et al., Cystic lesions and scrotal fluid collections in adults: Ultrasound findings. J Ultrasound, 2011. 14(4): p. 208-15. https://doi.org/10.1016/j.jus.2011.10.008.
    3. Ilangovan, G., et al., Torsion of Epididymal Cyst: A Case Report with Review of Literature. Cureus, 2023. 15(12): p. e51158. https://doi.org/10.7759/cureus.51158.
    4. O'Kelly, F., et al., The futility of continued surveillance of epididymal cysts - A study of the prevalence and clinico-demographics in pre- vs. post-pubertal boys. Can Urol Assoc J, 2019. 13(12): p. E398-e403. https://doi.org/10.5489/cuaj.5667.
    5. Mazketly, M., et al., A rare case of polyorchidism in a 40-year-old man. A case report. Ann Med Surg (Lond), 2021. 66: p. 102389. https://doi.org/10.1016/j.amsu.2021.102389.
    6. Weatherly, D., et al., Epididymal Cysts: Are They Associated with Infertility? Am J Mens Health, 2018. 12(3): p. 612-616. https://doi.org/10.1177/1557988316644976.
    7. Homayoon, K., C.D. Suhre, and G.F. Steinhardt, Epididymal cysts in children: natural history. J Urol, 2004. 171(3): p. 1274-6. https://doi.org/10.1097/01.ju.0000110322.87053.99.
    8. Nickel, J.C., Chronic epididymitis: a practical approach to understanding and managing a difficult urologic enigma. Rev Urol, 2003. 5(4): p. 209-15.
    9. Nistal, M., et al., Cystic dysplasia of the epididymis: a disorder of mesonephric differentiation associated with renal maldevelopment. Virchows Arch, 2010. 456(6): p. 695-702. https://doi.org/10.1007/s00428-010-0906-8.
    10. Bendarska-Czerwińska, A., et al., Endocrine disorders and fertility and pregnancy: An update. Front Endocrinol (Lausanne), 2022. 13: p. 970439. https://doi.org/10.3389/fendo.2022.970439.
    11. Pieri, S., et al., A therapeutic alternative in the treatment of epididymal cysts: percutaneous sclerotherapy. Radiol Med, 2003. 105(5-6): p. 462-70.
    12. Schoina, E., et al., Symptomatic Intraparenchymal Epididymal Cysts: Description of 11 cases. Folia Med Cracov, 2023. 63(4): p. 49-55. https://doi.org/10.24425/fmc.2023.148757.
    13. Ebadi, M., et al., Sarcopenia in cirrhosis: from pathogenesis to interventions. 2019. 54(10): p. 845- 859. https://doi.org/10.1007/s00535-019-01605-6.
    14. Uzumcu, M. and R. Zachow, Developmental exposure to environmental endocrine disruptors: consequences within the ovary and on female reproductive function. Reprod Toxicol, 2007. 23(3): p. 337-52. https://doi.org/10.1016/j.reprotox.2006.10.006.
    15. Rolfo, A. and A.M. Nuzzo, Fetal-Maternal Exposure to Endocrine Disruptors: Correlation with Diet Intake and Pregnancy Outcomes. 2020. 12(6). https://doi.org/10.3390/nu12061744.
    16. Patil, V., S.M. Shetty, and S. Das, Common and Uncommon Presentation of Fluid within the Scrotal Spaces. Ultrasound Int Open, 2015. 1(2): p. E34-40. https://doi.org/10.1055/s-0035-1555919.
    17. Fernández-Ibieta, M., F. Villalon-Ferrero, and J.L. Ramos-García, Benign Scrotal Tumor in a Pediatric Patient: Epididymal Cyst. Case Reports in Urology, 2018. 2018: p. 1635635. https://doi.org/10.1155/2018/1635635.
    18. Boscarelli, A. and T. Bellini, Epididymal cyst in children. Eur J Pediatr, 2021. 180(9): p. 2723- 2729. https://doi.org/10.1007/s00431-021-04080-5.
    19. Silva, G.F., et al., Case report: Long term follow-up of a large unilateral epididymal cyst in a stallion used for teaching: Is this condition associated with infertility? Front Vet Sci, 2023. 10: p. 1145742. https://doi.org/10.3389/fvets.2023.1145742.
    20. Ravikanth, R., Varicocele with Concomitant Ipsilateral Intratesticular Spermatocele: A Rarity. J Med Ultrasound, 2018. 26(4): p. 224-225. https://doi.org/10.4103/JMU.JMU_32_18.

  • Downloads

  • How to Cite

    Arora, T., Akami , K. ., Kapur , N. ., & Nain , S. . (2024). Large Epididymal Cyst: A Tale of Three Testes. International Journal of Medicine, 12(2), 34-37. https://doi.org/10.14419/7fc6b721