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Presented by Theresa Chan, M.D. and prepared by Lynette S. Nichols, M.D.
Case 1: 17 year old male with a testes mass
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Question 1 of 1
1. Question
Week 127: Case 1
17 year old male with a testes mass/images/ChanT1a.JPG
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/images/ChanT1c.JPGCorrect
Answer: Epidermoid cyst
Histology: The testes shows a simple cyst within the parenchyma. The cyst is filled with keratinaceous material and lined by compressed squamous epithelium.
Discussion: Epidermoid cysts can occur in the testicular parenchyma, tunica albuginea or epididymis. They most commonly occur in the testicular parenchyma and accounts for 1% of testicular parenchymal masses. The cystic lesion must be carefully sampled to rule out teratoma. Dermoid cysts consist of squamous epithelium with skin appendages including hair follicles and sebaceous glands. One can find focal teratomatous components in a dermoid or epidermoid cyst without the lesion behaving as a teratoma. In contrast to germ cell tumors, intratubular germ cell neoplasia is not identified in adjacent testis in dermoid and epidermoid cysts. The presence of intratubular germ cell neoplasia would argue against a diagnosis of a dermoid or epidermoid cyst. Unlike mature teratoma, which has the potential to metastasize, dermoid and epidermoid cysts are benign.
Incorrect
Answer: Epidermoid cyst
Histology: The testes shows a simple cyst within the parenchyma. The cyst is filled with keratinaceous material and lined by compressed squamous epithelium.
Discussion: Epidermoid cysts can occur in the testicular parenchyma, tunica albuginea or epididymis. They most commonly occur in the testicular parenchyma and accounts for 1% of testicular parenchymal masses. The cystic lesion must be carefully sampled to rule out teratoma. Dermoid cysts consist of squamous epithelium with skin appendages including hair follicles and sebaceous glands. One can find focal teratomatous components in a dermoid or epidermoid cyst without the lesion behaving as a teratoma. In contrast to germ cell tumors, intratubular germ cell neoplasia is not identified in adjacent testis in dermoid and epidermoid cysts. The presence of intratubular germ cell neoplasia would argue against a diagnosis of a dermoid or epidermoid cyst. Unlike mature teratoma, which has the potential to metastasize, dermoid and epidermoid cysts are benign.
