Gonadal preservation in a simple testicular cyst

Simple cysts of testis with immunohistochemical evidence of mesothelial origin

Simple cysts of the testis are an uncommon lesion found in adults as well as infants. Only a few histological and immunohistochemical studies for this lesion have been reported because the lesion have rarely undergone surgical excision or histological confirmation. Herein is reported an autopsy case of simple cysts of the right testis found incidentally in an 84-year-old man who died of hepatocellular carcinoma. The cysts were multilocular, 12 x 8 mm in size, separated from the tunica albuginea and filled with transparent and colorless serous fluid. Histology and immunohistochemistry showed that the cystic lesion had flattened or cuboidal single-layered lining cells that were positive for cytokeratin AE1/AE3, calretinin, D2-40, HBME-1, mesothelin and thrombomodulin, indicating its mesothelial origin. To the authors' knowledge this is the first English-language report describing the origin of simple cysts of the testis. Although the exact pathogenesis of simple cysts of the testis is as yet unknown and there seems to be more than one etiology, at least in the present case the cysts were confirmed to correspond to mesothelial inclusions.

Sonography of Pediatric Scrotal Swelling

Sonography is the preferred imaging method for the evaluation of pediatric scrotal swelling. By identifying the site of origin and whether a mass is solid or cystic, the diagnosis is usually readily made, making ultrasound especially valuable in patient management. Scrotal pathology differs in pediatric patients, especially prior to puberty, making understanding of pediatric conditions essential. This article reviews the common intra- and extratesticular causes of pediatric scrotal swelling and their sonographic appearances.

Simple testicular cyst: a rare cause of scrotal swelling in infancy

A simple testicular cyst is a rare cause of scrotal swelling in infancy. Only 10 cases have been reported in children less than two years of age in the English literature. Pathogenesis of the lesion is unclear. Preoperative diagnosis is possible using ultrasonography (US). Testis-sparing surgery with simple enucleation of the cyst has a favorable outcome. We report two patients with a simple testicular cyst, who were 9 and 8 months of age. The first case was referred with a presumptive diagnosis of hydrocele, and the second infant was admitted with a history of testicular swelling. Ultrasonography provided accurate preoperative diagnosis in both of the cases. The patients were successfully treated with testis-sparing surgery with outstanding long-term results. This unusual lesion of infancy should be considered in the differential diagnosis of a scrotal mass.