[P-110]
Concurrent Testicular Epidermoid Cyst and Testicular Dermoid Cyst: A Case Report
Emir Akıncıoğlu1, Fuat Kızılay1, Banu Sarsık Kumbaracı2, Barış Altay12Department of Pathology, Ege University, İzmir, Turkey
Introduction
Bilateral testicular tumor incidence is reported to be approximately 1.5%. Synchronous bilateral testicular tumors are less than 0.5% of all testicular tumors. We present our case of different histological types of synchronous bilateral testicular tumors because of it’s rarity.
Case report
24 –year-old man was admitted to our clinic with the complaint of swelling in the left testicle. Physical examination revealed painless, hard left testicle, while the right testicle was in normal size and consistency. The ultrasound reported 20 mm diameter mass showing cystic degenerative calcifications in the right testicle and 54x42 mm nonvascular mass in the left testicle. The patient’s AFP, βHCG and LDH values were found in the normal range. The patient was examined by whole-body computed tomography and mass lesions supporting the diagnosis of tumor were seen in both testicles (Image 1). There was no evidence of systemic metastasis.
First, left inguinal orchiectomy was performed. Macroscopic examination of the left spermatic cord, epididymis and tunica albuginea was normal. Left testicle was opened for OncoTESE. Tunica albuginea was incised and pasty, keratinized necrotic tissue was encountered (Photo 1).
Tunica albuginea was found to be completely filled with this material, normal testicular parenchyma was not detected. Then right testicle was delivered as scrotal. 2x2x1 cm mass was seen macroscopically and similar material also discharged from this mass (Photo 2).
Partial orchiectomy and OncoTESE were performed for right testicle. Surgery was terminated upon the benign frozen examination. 1.5 cm cystic structure similar to left side was noticed in the right testicle in histopathologic examination (figure 1). Cyst structure, granulation tissue in the surrounding parenchyma and leydig cell hyperplasia was seen in microscopic evaluation (figure 2). Keratinized squamous epithelium and cyst structure containing sebaceous cysts were noted in the histopathologic examination of the right testicle (figure 3).
Discussion
Consequently, both the epidermoid cysts and dermoid cysts are rare, a concurrent case has not been reported before. Inguinal orchiectomy is the current approach if testicular malignancy is suspected with history, physical examination, laboratory and imaging methods. Testis-sparing approach is an alternative to be considered in benign like leisons and pediatric age.
(Fotoğraf 1 – Keratinden ve dejenere olmuş parankimden oluşan sol testis ve içeriği)
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(Fotoğraf 2 – Sağ testisteki kitle ve sol testistekine benzer şekilde boşalan keratinize materyal)
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(Görüntü 1 – Testislerdeki Kitle Lezyonları)
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(Resim 1 - Sol radikal orşiektomi ve sağ parsiyel orşiektomi materyali)
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(Resim 2 - Sol testis; Skuamöz epitel ve keratin (Hematoksilern&Eozin x100;) )
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(Resim 3 -Sağ testis; Skuamöz epitel ile keratin (mavi ok) ve adneksiyal yapılar (yeşil ok) (Hematoksilern&Eozin x100;) )
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