Simple intratesticular cysts in children: preoperative sonographic diagnosis and histological correlation

Background. Simple intratesticular cysts are rare in children and have been considered the most uncommon cause of scrotal cystic masses in this age gr oup. The exact etiology of these lesions is still unclear. High-resolution ultrasonography has been proved to be a reliable and accurate imaging modal ity in the evaluation of scrotal abnormalities in children. Patients and methods. We report the sonographic findings in five boys aged from 4 to 10 months Who presented with a scrotal mass and had a simple intr atesticular cyst, Ultrasonography showed that all of them displayed a chara cteristic appearance and provided the necessary information to perform cons ervative surgery, with testicular preservation in four infants. In one infa nt, the cyst involved most of the testis, and an orchiectomy was performed. Results. Pathological examination revealed a single smooth-walled cystic st ructure, with clear and serous fluid, lined with flattened epithelial cells in all of the infants. Conclusion. Our findings appear to support the hypothesis that these cysts could correspond to mesothelial inclusions. Sonographically, differential d iagnosis should include mainly epidermoid cysts of the testis, which are mo stly cystic but characteristically contain some echoes within them, in cont rast to simple cysts and cysts of the tunica albuginea, which lie outside t he testicular parenchyma.