Cystic intratesticular lesions in pediatric patients.
OBJECTIVE
Intratesticular cysts are a rare clinical entity in the pediatric population. Recently, testes sparing surgery has been recommended. We share our experience with the management of pediatric testicular cysts.


METHODS
A retrospective review of all pediatric patients referred for intratesticular cysts was conducted at a single pediatric institution from 2002 to 2010. Charts were evaluated for patient demographics, diagnosis, and management.


RESULTS
Seven patients were identified and included in this series. After partial orchiectomy, the final diagnosis in three patients was epidermoid cyst. Three further patients were diagnosed as mature cystic teratoma, with two of these demonstrating adjacent intra-tubular germ cell neoplasia (ITGCN). One cyst in the series underwent spontaneous resolution after eight months.


CONCLUSIONS
All of the cystic lesions in our case series were benign with one undergoing complete resolution. The remainder became smaller and developed a solid component prompting surgery. The pre-pubertal findings of ITGCN in two patients raise a dilemma regarding the optimal long-term management for these patients. Initial conservative observation is an option for the majority of pre-pubertal cystic testicular lesions until such time that testis sparing surgery is deemed technically feasible. Testes sparing surgery should be advocated in those patients undergoing surgical management.
Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada. natman@interchange.ubc.ca
Nathan A
NA
Hoag
Kourosh
K
Afshar
David
D
Youssef
John S T
JS
Masterson
James
J
Murphy
Andrew E
AE
Macneily
D001955:British Columbia / Q000453:epidemiology; D003456:Cryptorchidism / Q000150:complications / Q000000981:diagnostic imaging; D003560:Cysts / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D004814:Epidermal Cyst / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009919:Orchiectomy / Q000379:methods*; D059351:Organ Sparing Treatments; D012189:Retrospective Studies; D013724:Teratoma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D013733:Testicular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D014463:Ultrasonography
Cyst; Pediatric; Surgical treatment; Testis-sparing surgery; Urology