Cystic Testicular Lesion in an Infant: Diagnostic and Therapeutic Considerations

Introduction: Prepuberal testicular tumors are usually benign. Cystic lesions constitute a wide group of scrotal benign masses differentials in children. An appropriate evaluation comprises a complete clinical exam, Doppler ultrasonography and tumor markers. If a benign lesion is likely, testis-sparing surgery is the treatment of choice. Objective: To describe the case of an infant with a cystic testicular mass compatible with epidermoid cyst. Furthermore, to discuss the most relevant clinical, diagnostic and therapeutic aspects of prepubertal testicular lesions. Case report: An infant was admitted due to identification of a painless well-defined testicular mass of approximately 1 cm of diameter. Ultrasonography showed an intraparenchymal simple cyst and tumor markers were negative. Complete enucleation was performed via scrotal approach without postoperative complications. Histopathological study was compatible with a testicular epidermoid cyst. There was no evidence of recurrence or atrophy at 3-year follow-up. Discussion and conclusion: Since most prepuberal testicular tumors are benign, testis-sparing surgery constitutes a therapeutic alternative in small, circumscribed, avascular lesions with negative tumor markers.