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Case 52

Cystadenoma of the epididymis

A young male with a scrotal mass

Ken Wong

This 35 year old male presents with a right testicular swelling. He is otherwise in good health. The only history of note is a cystic disorder of the kidneys.

Findings

The right testicle appears normal. A large right hydrocele is present. A cystic lesion measuring 20 x 26 mm is seen within the right epididymis. There is an associated thick wall and a mural nodule measuring 7 mm in size.

The cystic renal disease was a part of the von Hippel-Lindau syndrome.

Diagnosis

Cystadenoma of the epididymis, von Hippel-Lindau syndrome

Discussion

Papillary cystadenomas are the second most common benign tumours of the epididymis. They occur in young adults and are usually located in the head of the epididymis. In 1/3 of the cases, they are bilateral. Approximately 10%-40% of patients with von Hippel-Lindau disease have papillary cystadenomas. Differential diagnosis includes epididymal cysts, spermatoceles, teratomas, and adenomatoid tumours.

See also Case 51, a related case.

References

Hricak H, Hamm B, Kim B. Imaging of the scrotum. Raven Press 1995. p103.

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