Epididimal Cyst in Children: A Single-Institutional Experience
Urology Journal,
Vol. 22 No. 02 (2025),
2 March 2025
,
Page 83-88
https://doi.org/10.22037/uj.v21i.8003
Abstract
Purpose: Simple epididymal cysts (EC) are rare in childhood and are mostly diagnosed at puberty. Although there is no consensus on the treatment, a conservative approach is generally preferred. To evaluate patients diagnosed with EC at our clinic in terms of presenting symptoms, diagnosis, and treatment methods.
Materials and Methods: Data of patients treated for epididymal cysts at our institution between March 2012 and March 2023 were retrospectively analyzed in terms of age, symptomatology, diagnostic method, treatment method, and outcomes. In all cases, the diagnosis of EC was based on physical examination with scrotal ultrasonography (US) confirmation.
Results: A total of 1829 patients underwent scrotal Doppler US, and EC was detected in 72 patients (10.7%). The median follow-up period of the 43 patients was 21.7 (6-80 months). Of these, 9 were bilateral (12.5%). The mean age of the patients at presentation was 14.8 years. Forty-one patients had scrotal pain, 12 had scrotal swelling, and 19 incidentally had EC. The cysts were between 1.2- 37 mm. Only 3 (4.1%) patients required surgical excision due to persistent pain.
Conclusion: EC is a benign lesion, and treatment approaches are usually conservative. Surgical excision is recommended for patients with persistent scrotal pain or an acute scrotum.
- Epididymal cysts
- Children
- scrotal ultrasonography
How to Cite
References
REFERENCES:
Mukendi AM. Bilateral epididymal cyst with spontaneous resolution. Clin Case Rep. 2020;8:2689-91.
Rifkin MD, Kurtz AB, Goldberg BB. Epididymis examined by ultrasound. Correlation with pathology. Radiology. 1984 ;151:187-90.
Fernández-Ibieta M, Villalon-Ferrero F, Ramos-García JL. Benign Scrotal Tumor in a Pediatric Patient: Epididymal Cyst. Case Rep Urol. 2018;20;2018:1635635.
Munden MM and Trautwein LM: Scrotal pathol-ogy in pediatrics with sonographic imaging. CurrProbl Diagn Radiol. 2000;29:185.
Blau H, Freud E, Mussaffi H et al. Urogenital abnormalities in male children with cystic fibrosis. Arch Dis Child. 2002;87:135–8.
Belet U, Danaci M, Sarikaya S et al. Prevalence of epididymal, seminal vesicle, prostate, and testicular cysts in autosomal dominant polycystic kidney disease. Urology. 2002;60:138–41.
Joerger M, Koeberle D, Neumann HP, Gillessen S. Von Hippel-Lindau disease--a rare disease important to recognize. Onkologie. 2005;28:159–63.
Sheih CP, Hung CS, Wei CF, Lin CY. Cystic dilatations within the pelvis in patients with ipsilateral renal agenesis or dysplasia. J Urol 1990;144:324–7.
O'Kelly F, McAlpine K, Abdeen N et al. The futility of continued surveillance of epididymal cysts-a study of the prevalence and clinico-demographics in pre- vs. post-pubertal boys. Can Urol Assoc J. 2019;13:398–403.
Homayoon K, Suhre CD, Steinhardt GF. Epididymal cysts in children: natural history. J Urol. 2004;171:1274–6.
Posey ZQ, Ahn HJ, Junewick J, Chen JJ, Steinhardt GF Rate and associations of epididymal cysts on pediatric scrotal ultrasound. J Urol. 2010;184:1739–42.
Erikci V, Hoşgör M, Aksoy N et al. Management of epididymal cysts in childhood. J Pediatr Surg. 2013;48:2153-6.
Sharpe RM. Hormones and testis development and the possible adverse effects of environmental chemicals. Toxicol Lett. 2001;120:221-32.
Skakkebaek NE, Rajpert-De Meyts E, Main KM. Testicular dysgenesis syndrome: an increasingly common developmental disorder with environmental aspects. Hum Reprod. 2001;16:972-8.
Wollin M, Marshall FF, Fink MP, Malhotra R, Diamond DA. Aberrant epididymal tissue: a significant clinical entity. J Urol. 1987 ;138:1247-50.
McLachlan JA, Newbold RR, Burow ME, Li SF. From malformations to molecular mechanisms in the male: three decades of research on endocrine disrupters. APMIS. 2001;109:263-72.
Patoulias D, Kalogirou M, Patoulias I. Intraparenchymal Epididymal Cyst (IEC) 4 cm in Diameter in a 15-Year Old Male Patient; a Case Report and Review of the Literature. Acta Medica (Hradec Kralove). 2016;59:137-9.
Nistal M, González-Peramato P, Sousa G et al. Cystic dysplasia of the epididymis: a disorder of mesonephric differentiation associated with renal maldevelopment. Virchows Arch. 2010;456:695-702.
Afsarlar CE, Elizondo R, Yilmaz E et al. Ultrasonographic findings in the epididymis of pediatric patients with testicular torsion. J Pediatr Urol. 2017;13:393.e1-6.
Arora BK, Arora R, Arora A. A randomised study of management modalities in epididymal cyst. Int Surg J. 2019;6:340-4.
Yin Z, Meng X. Chapter 4 -General techniques of scrotoscopic surgery. In: J Yang ed. Scrotoscopic Surgery. Cambridge, MA: Academic Press; 2019:23-53.
Karaman A, Afşarlar CE, Arda N. Epididymal cyst: not always a benign condition. Int J Urol. 2013;20:457-8.
Ozaal AMOM, Pragalathan B, Lavanya S, Sarma ST. Torsion of an Epididymal Cyst: A Rare Finding on Scrotal Exploration for Acute Scrotum. Case Rep Urol. 2020;22;2020:8858606.
Qin C, Yang J, Zhang R et al. The Application of Scrotoscope-Assisted Minimally Invasive Excision for Epididymal Mass: An Initial Report. Front Surg. 2022;24;9:804803.
Prader A. Testicular size: assessment and clinical importance. Triangle. 1966;7:240-3.
Akyüz O, Ergün M, Kılıç B et al. Testicular volume, and penile length of children aged 0-10 years in Turkey: Do measurements vary among geographical regions?. Androl Bul 2021;23:1−6
Welliver C, Cardona-Grau D, Elebyjian L, Feustel PJ, Kogan BA. Surprising interobserver and intra-observer variability in pediatric testicular ultrasound volumes. J Pediatr Urol. 2019;15:386.e1-6.
Boscarelli A, Bellini T. Epididymal cyst in children. Eur J Pediatr. 2021;180:2723-9.
Niedzielski J, Miodek M, Krakós M. Epididymal cysts in childhood - conservative or surgical approach? Pol Przegl Chir. 2012;84:406-10.
Chillón Sempere FS, Domínguez Hinarejos C, Serrano Durbá A et al. Quistes epididimarios en la infancia [Epididymal cysts in childhood]. Arch Esp Urol. 2005;58:325-8.
- Abstract Viewed: 469 times
- 8003/pdf Downloaded: 305 times