Testicular epidermoid cyst: a case for conservative surgery.

We present two case reports of benign testicular epidermoid cysts, along with a review of the literature. This rare cause of intra-testicular swelling has often been treated by orchiectomy in the past. Evidence in the literature suggests a more conservative approach can be adopted safely, provided certain diagnostic criteria are observed. A 24-year-old man presented with a painless 2 cm nodule in the lower pole of his right testicle. Ultrasonography revealed a hypoechoic intra-testicular circumscribed lesion with normal surrounding parenchyma. The levels of serum testicular markers human chorionic gonado-trophin (HCG) and alpha-fetoprotein were normal. Inguinal testicular exploration revealed a solid intra-testicular lesion. On opening the tunica albuginea a 1 cm solid lesion with calcific exterior was easily enucleated, leaving a normal testicular Fig 1. Testis with non infiltrating intrateticular lesion visible on opening the tunica albuginea. Fig 2. Epidermoid cyst after simple enucleation. parenchymal bed. The lesion contained yellow-white keratinous debris. The tunica was closed with preservation of the testicle. Histopathology confirmed a benign epidermoid cyst and the patient remained well at one year follow-up. (Figures 1 and 2). CASE 2 A 23-year-old man presented with a painless 1 cm swelling in his right testicle. Ultra-sonography showed a round 1 cm solid intra-testicular lesion with a hypoechoic centre and