A rare finding of testicular epidermoid keratinized cyst in a prepubertal boy: case report and management standardization

Testicular epidermoid cysts (TECs) are rare, benign lesions that can also mimic malignant testicular masses. Accurate preoperative diagnosis is essential for proper management. A 13-year-old male presented with a painless solid mass in the left testicle. Serum tumor markers were normal. Ultrasound, CEUS and MRI findings were consistent with TEC. Surgical enucleation of the mass was performed, after ruling out malignancy through intraoperative frozen section examination. Histopathology confirmed diagnosis of keratin-filled epidermoid cyst. At 3-month follow-up, the patient is well-being and scrotal US is normal. This case highlights the importance of considering epidermoid cysts in the differential diagnosis of testicular masses in young males. Ultrasound is the first-line imaging modality in the assessment of any testicular masses. Other imaging modalities such as CEUS, elastography and MRI can be helpful to distinguish between benign and malignant lesions. Testis-sparing surgery can be safely performed, after ruling out malignancy through intraoperative frozen-section analysis.