Vol. 5, Issue 1, Part A (2023)

Background: Testicular tumors encompass a spectrum of neoplastic entities, with testicular germ cell tumors being the most prevalent. However, among the rarest pathological occurrences in this domain are epidermoid cysts of the testis. These cysts are characterized by the presence of stratified squamous epithelium, and due to their scarcity, only a limited number of case reports have been documented in the existing medical literature.
Case Presentation: A 31-year-old man, seeking fertility evaluation due to two years of unsuccessful attempts with his wife, presented with a cystic mass and dull pain in the right testicle. Ultrasound revealed an isoechoic, encapsulated tissue mass in the lower pole. Computed tomography identified an 8 mm lymph node near the iliac vessels. Seminal fluid analysis showed normospermia, and laboratory tests were within normal limits. Testicle resection uncovered an unexpected diagnosis-epidermoid cyst with an inflammatory cholesterol granuloma. This case underscores the value of organ-sparing surgery and collaborative diagnostics in managing rare testicular pathologies.
Conclusions: This case highlights the complexities in diagnosing and managing testicular epidermoid cysts, emphasizing the need for a detailed diagnostic approach. The advocacy for organ-sparing surgery in small testicular tumors underscores the importance of tailored interventions. This contribution aims to enhance awareness and knowledge surrounding rare testicular pathologies, facilitating improved clinical decision-making.