Unusual MR imagings of an incidental testicular epidermoid cyst: A case report

Testicular epidermoid cyst is usually incidentally found during a physical check-up. It is an uncommon intratesticular benign tumor. Because testicular epidermoid cyst is usually encapsulated by a fibrous wall and filled with keratinous debris, it usually appears solid-like on sonographic and magnetic resonance (MR) imagings. Typically, testicular epidermoid cyst has a target appearance on MR imagings. Here we present a case of testicular epidermoid cyst, which was incidentally detected by ultrasound during an episode of acute epididymitis. This mass showed an unusual purely cystic structure with thick wall, which had low signal intensity wall on MR imagings. Benign testicular epidermoid cyst was suspected from the preoperative sonographic and MR study. Enucleation of the testicular mass was done and the final pathologic result was testicular epidermoid cyst. In our case, preoperative imaging findings provided information to the surgeons to attempt testis-sparing surgery instead of orchiectomy.