Indian Journal of Urology
CASE REPORT
Year
: 2002  |  Volume : 18  |  Issue : 2  |  Page : 175--176

Mesothelial cyst of epididymis - a rare presentation


Shubha N Rao, Erel Diaz, Shivananda Prabhu, TK Susheel Kumar, Paul Jose 
 Department of General Surgery, Kasturba Medical College, Mangalore, India

Correspondence Address:
Shubha N Rao
Department of General Surgery, KMC Hospital, Attavar, Mangalore - 575001
India

Abstract

Mesothelial cysts of epididymis are very rare. Their clinical significance lies in their presentation as discrete testicular masses often diagnosed as hydroceles prior to removal. We report our experience of a cyst lined by mesothelial cells lying at the upper pole of the testes, from the epidi­dyinis.



How to cite this article:
Rao SN, Diaz E, Prabhu S, Susheel Kumar T K, Jose P. Mesothelial cyst of epididymis - a rare presentation.Indian J Urol 2002;18:175-176


How to cite this URL:
Rao SN, Diaz E, Prabhu S, Susheel Kumar T K, Jose P. Mesothelial cyst of epididymis - a rare presentation. Indian J Urol [serial online] 2002 [cited 2022 May 20 ];18:175-176
Available from: https://www.indianjurol.com/text.asp?2002/18/2/175/37635


Full Text

 Introduction



The use of ultrasound to screen scrotal diseases has gen­erated data to suggest that testicular cysts are not at all rare (Leung et al 1987). But, cysts of epididymis turning out to be mesothelial cysts are extremely rare.

We describe one such case and aim at clarifying its ori­gin.

 Patients and Methods



A 58-year-old man presented with swelling in both sides of the scrotum of one-year's duration. Examination revealed bilateral, cystic swellings in both sides of the scrotum which were brilliantly transilluminant, fluctuant and non-tender.

At operation, a sac eversion was done for the hydrocele on the left side and the right side revealed a cyst at the upper pole of the testis which was carefully excised with­out damaging any of the nearby vital structures. Histopatho­logic examination revealed a 3 x 2 x 0.5 cm cystic mass. the outer surface of which was membranous and contained serous fluid. The microscopic examination showed epidi­dymal cyst lined by flattened mesothelial cells [Figure 1]. The patient recovered without complications.

 Results



The lesion was a cystic mass, containing serous fluid and was lined by flattened mesothelial cells.

 Discussion



The etiology of these cysts are not known but in cysts of tunica albuginea, it has been postulated that trauma and subsequent haemorrhage into tunica albuginea could lead to their formation (Frater 1929). [1] Arcadi (1952)[2] favoured an infectious etiology because he found evidence of tes­ticular inflammation in 2 of his cases.

Another theory could be that they arise from embry­onic remnants. Mostly cysts are found to be of epithelial origin. [3],[4] In one study done earlier, one of the cysts from tunica albuginea was lined by transitional like epithelium. The origin of the transitional like epithelium is unknown but a mesothelial origin from metaplasia of mature mes­othelium or from remains of mullerian duct has been sug­gested. [5]

An embryonic mechanism of cyst formation has been proposed. In the absence of symptoms or of a progressive increase in size surgical removal of a cyst of epididymis is not mandatory.

References

1Frater K. Cysts of tunica albuginea (cysts of testis). J Urol 1929; 21: 135-140.
2Arcadi JA. Cysts of tunica albuginea testis. J Urol 1952; 68: 613­-635.
3Mennemeyer RP, Mason JT. Non-neoplastic cystic lesions of the tunica albuginea : an electron microscopic and clinical study of 2 cases. J Urol 1979; 121: 373-375.
4Bryant J. Efferent ductule cyst of tunica albuginea. Urology 1986: 27: 172-173.
5Walker AN, Mills SE. Surgical pathology of tunica vaginalis testes and embryologically related mesothelium. Pathol Ann 1988; 23: 125-152.