Giant Epididymal Cyst in the Right Testicle: Case Report and Literature Review.
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Abstract
ABSTRACT
Introduction: Cystic intratesticular lesions can occur in the second and fourth decades of life and are typically identified via ultrasound. Testicular cysts, usually under 2 cm, result from epididymal-lymphatic obstruction or hormonal changes. Larger lesions with sperm and lymphocytes are spermatoceles. Epididymal cysts are asymptomatic but can cause discomfort or pain, sometimes requiring surgery.
Clinical case: A 38-year-old male with no chronic diseases presented with a giant tumor in the right testicle, experiencing pain and hypersensitivity. Physical examination and ultrasound revealed an irregular, painful testicular tumor and a right epididymal cyst. A right epididymal tumor excision was performed successfully.
Discussion: Testicular cysts are benign and represent 20-40% of benign testicular tumors. They may arise due to idiopathic, infectious, or traumatic causes with no established risk factors. Diagnosis is often incidental and involves physical examination and imaging techniques like ultrasound. Management is conservative for asymptomatic cases, while symptomatic cases may require surgical intervention that involves careful separation of the cyst from the adhered area.
Conclusion: An epididymal cyst is a common pathology in males worldwide, occupying up to 40% of the masses in the testes at the time of a urological assessment. It is a collection at the testicular level of hyaline content and usually measures < 2 cm. They are generally asymptomatic, but when their size exceeds 2 cm or causes symptomatology, it is important to know the therapeutic options that can be offered to patients. In the case of our patient, as it is an epididymal cyst with a diameter of 5 cm and with additional symptomatology, the ideal management was surgical resection, showing adequate evolution in the postoperative follow-up.
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References
I. Rumack, C. M., & Levine, D. (Eds.). (2023). Diagnostic ultrasound E-book: Diagnostic ultrasound E-book (6th ed.). Elsevier.
II. Buttaro, T. M., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2020). Primary care: Interprofessional collaborative practice (6th ed.). Elsevier - Health Sciences Division.
III. Slater, T. A., Waduud, M. A., & Ahmed, N. (2021). Pocketbook of differential diagnosis(5th ed.). Elsevier Health Sciences.
IV. Wein, A. J. (2020). Campbell-Walsh urology 12th edition review (A. W. Partin, C. A. Peters, L. R. Kavoussi, R. R. Dmochowski, & A. J. Wein, Eds.; 3rd ed.). Elsevier - Health Sciences Division.
V. Vafadar, M., Rakhshankhah, N., Salek, M., & Zarei, E. (2023). Torsion of epididymal Cyst as a cause of acute Scrotum in a child. Urology Case Reports, 48(102417), 102417.
a. https://doi.org/10.1016/j.eucr.2023.10241
VI. Giwerc, A., Masson-Lecomte, A., Desgrandchamps, F., & Méria, P. (2019). Quistes y tumores del epidídimo. EMC - Urología, 51(3), 1–10. https://doi.org/10.1016/s1761-3310(19)42719-9
VII. Hassan, M. A. (2022). Epididymal cyst: An etiology of scrotal pain in children. Journal of Pediatric Surgery Case Reports, 78(102183), 102183. https://doi.org/10.1016/j.epsc.2022.102183
VIII. Sadler, T. W. (2023). Langman. Embriología médica (14th ed.). Lippincott Williams & Wilkins.
IX. Wing, E. J., & Schiffman, F. J. (Eds.). (2021). Cecil essentials of medicine E-book: Cecil essentials of medicine E-book (10th ed.). Elsevier.
X. Hagen-Ansert, S. L. (2023). Textbook of diagnostic sonography: 2-Volume set (9th ed.). Elsevier - Health Sciences Division.
XI. Rico, E. B., Alba, A. B., Gasión, J. P. B., & Marco, S. L. (2024). Atlas quirúrgico de urología práctica.