睪丸表皮樣囊腫之保留生育力的部分睪丸切除術: 病例報告及文獻回顧

康庭碩、陳柏華

彰化基督教醫院 外科部 泌尿科

Testicular epidermoid cyst following by fertility-Sparing partial orchiectomy: a case report with literature review

Ting-Shuo Kang, Pao-Hwa Chen

Divisions of Urology, Department of Surgery, Changhua Christian Hospital

Introduction:

Testicular epidermoid cysts (TECs) are rare benign lesions, accounting for only 1-2% of all testicular tumors. The standard treatment has historically been radical orchiectomy due to the difficulty in preoperatively ruling out malignancy. However, testis-sparing surgery has emerged as a viable option for carefully selected cases. Proper diagnosis and management of TECs is crucial to avoid overtreatment while ensuring optimal oncological outcomes. Here we present a rare case of an epidermoid cyst treated with partial orchiectomy.

Case presentation:

A 35-year-old male with no underlying disease presented with right scrotal enlargement for 2 months. He occasionally experienced mild scrotal pain, which was manageable with analgesics. There was no family history of testicular malignancy. Physical examination revealed a palpable hard mass in the right scrotum. Scrotal ultrasound showed a heterogenous mass over lower pole of right scrotum without central blood flow. Tumor markers, including alpha-fetoprotein (1.7 ng/ml), hCG (<0.6 mIU/mL), and LDH (225 U/L), were all within normal limits. A pelvic CT showed a 3.6 cm cystic lesion with mild wall thickening and calcification in the right testis, but no significant lymph node involvement was noted.

The patient underwent a partial orchiectomy. During the surgery, a well-circumscribed mass compressing the right testis was identified, and frozen section pathology confirmed a benign lesion. Consequently, orchidopexy with Darto’s pouch fixation was performed. Final pathology revealed an epidermoid cyst.