Testicular Epidermoid Cysts

Testicular epidermoid cysts are benign and a cure is possible with complete resection.

On ultrasound, a testicular epidermoid cyst appears as a heterogeneous intratesticular mass without flow on color Doppler. Echogenic foci with posterior sonic shadowing representing calcifications may be present. The lesion may have a hypoechoic or echogenic rim. These findings are nonspecific and usually resection is carried out. The more specific onion skin appearance of alternating hypo- and hyperechoic layers may be present in some cases.

On MRI, T2-weighted images show a hyperintense mass surrounded by hypointense rim. Low-signal-intensity foci representing calcifications may or may not be present. Contrast enhancement is typically not seen. The typical onion skin or target appearance may be present in some cases.

References

Cho JH, Chang JC, Park BH, Lee JG, Son CH. Sonographic and MR imaging findings of testicular epidermoid cysts. AJR Am J Roentgenol. 2002 Mar;178(3):743-8.