An Extratesticular Intrascrotal Right Epidermoid Cyst

Clinical History

A 60-year old man presented to the hospital after he had noticed a swollen structure posterior to his right testicle. Upon clinical evaluation, the structure felt to be outside the testis, suggestive of an epididymal cyst. The tumour markers were negative. An ultrasound of the testes was requested for further evaluation.

Case Description

Using a high frequency (15MHz) linear transducer, ultrasound revealed a roundish lesion within the right hemiscrotum with concentric morphology and no internal vascularity. The lesion appears as a concentric ring of alternating echogenicity with a well-defined outline and no internal vascularity. Ultrasound features were in keeping with an intrascrotal extratesticular epidermoid cyst and this corresponded with the site of concern the patient pointed at during the ultrasound encounter.

Diagnosis/ Discussion/ Treatment/ Follow up

The ultrasound report was sent to the referring clinician. At the time of compiling this report, the patient was known to have been managed conservatively as surgery is not clinically indicated.

Epidermoid cysts are uncommon benign intratesticular or intrascrotal lesions encountered sonographically. They present as painless swelling or lump within the scrotum.

Intrascrotal extratesticular epidermoid cysts are reportedly rare in the current literature. Ultrasound is the ideal imaging modality of choice in examining the scrotum for masses or lumps felt.