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What Is The Difference Between An Epidermoid And An Epididymal Cyst?
Question: Went to urologist for some intermittent pain in right testicle. He manually performs an exam, and says that everything feels normal—no masses, torsion. Sends me for ultrasound anyway for thoroughness.
The report is below.
I'm hoping for some guidance with understanding and informing what questions/follow-up I ask of my urologist.
As to the 5mm epididymal cyst, what's up with the rim calcification? I've read that epidermoid cysts with calcifications can be difficult to differentiate from TC.
What is the difference between an epidermoid and an epididymal cyst?
As to the 9mm epididymal "echogenic focus", what do I make of this? The radiologist notes "probable lipomatous lesion". I don't see a ton of information on that online, aside from mention of liposarcoma of the epididymis, which looks concerning.
Thanks in advance for any thoughts.
FINDINGS:
RIGHT SCROTUM: Right testis echogenicity: Normal.
Right testis size: 4.9 cm x 2.7 cm x 3.6 cm Right testicular lesions: None. Right testis duplex Doppler evaluation: Normal. Right epididymis: Normal aside from a 5 mm cyst with rim calcification in the body.
Right hydrocele: None. Right varicocele: None.
LEFT SCROTUM:
Left testis echogenicity: Normal.
Left testis size: : 5.5 cm x 2.5 cm x 3.2 cm
Left testicular lesions: None.
Left testis duplex Doppler evaluation: Normal.
Left epididymis: Normal size and vascularity. 9 mm echogenic focus in the left epididymal head, possibly a small lipomatous lesion.
Left hydrocele: None.
Left varicocele: None. (<.2.5mm)
IMPRESSION:
9 mm echogenic focus in the left epididymal head, possibly a small lipomatous lesion.
5 mm calcification in the right epididymal body.
Otherwise, normal scrotal ultrasound.
The report is below.
I'm hoping for some guidance with understanding and informing what questions/follow-up I ask of my urologist.
As to the 5mm epididymal cyst, what's up with the rim calcification? I've read that epidermoid cysts with calcifications can be difficult to differentiate from TC.
What is the difference between an epidermoid and an epididymal cyst?
As to the 9mm epididymal "echogenic focus", what do I make of this? The radiologist notes "probable lipomatous lesion". I don't see a ton of information on that online, aside from mention of liposarcoma of the epididymis, which looks concerning.
Thanks in advance for any thoughts.
FINDINGS:
RIGHT SCROTUM: Right testis echogenicity: Normal.
Right testis size: 4.9 cm x 2.7 cm x 3.6 cm Right testicular lesions: None. Right testis duplex Doppler evaluation: Normal. Right epididymis: Normal aside from a 5 mm cyst with rim calcification in the body.
Right hydrocele: None. Right varicocele: None.
LEFT SCROTUM:
Left testis echogenicity: Normal.
Left testis size: : 5.5 cm x 2.5 cm x 3.2 cm
Left testicular lesions: None.
Left testis duplex Doppler evaluation: Normal.
Left epididymis: Normal size and vascularity. 9 mm echogenic focus in the left epididymal head, possibly a small lipomatous lesion.
Left hydrocele: None.
Left varicocele: None. (<.2.5mm)
IMPRESSION:
9 mm echogenic focus in the left epididymal head, possibly a small lipomatous lesion.
5 mm calcification in the right epididymal body.
Otherwise, normal scrotal ultrasound.
Brief Answer:
no need to worry
Detailed Answer:
Dear MR.
Considering all these findings there is no need to be worried since no signs of malignancy are present.
First, ultrasound may have some limitations, but it can pretty accurately rule out testicular cancer baed on location since such cancers are inside testicles and not on epididimis or outer layers. Second, size of 5mm or 8mm is very small, and although cancer can be of that size, these are usually larger than 1cm.
Epididmal cyst is fluid filled cyst that originates from epididymis which is a duct-like organ that connects the testis to the vas deferens. Epidermoid cyst is located in subcutaneus tissue and it is usually easily palpable. So both cysts are benign but also here we dont have epidermoid cyst, but epididmal cyst and in these cysts calcifications are commonly found and are not sign of malignancy. In addition, TC would have different doppler pattern with pathologic vascularity.
Regarding lipomatous tissue this is also benign and this represent lipoma of the cord which is also common finding in asymptomatic patients. Liposarcoma is extremely rare, it would have different symptoms and sonographic signs. If you want to ease your mind the only more accurate imaging test would be MRI, and you can check seminoma markers as well. However, I dont think this is necessary in your case as no suspicious lesions are found. Wish you good health. Regards
no need to worry
Detailed Answer:
Dear MR.
Considering all these findings there is no need to be worried since no signs of malignancy are present.
First, ultrasound may have some limitations, but it can pretty accurately rule out testicular cancer baed on location since such cancers are inside testicles and not on epididimis or outer layers. Second, size of 5mm or 8mm is very small, and although cancer can be of that size, these are usually larger than 1cm.
Epididmal cyst is fluid filled cyst that originates from epididymis which is a duct-like organ that connects the testis to the vas deferens. Epidermoid cyst is located in subcutaneus tissue and it is usually easily palpable. So both cysts are benign but also here we dont have epidermoid cyst, but epididmal cyst and in these cysts calcifications are commonly found and are not sign of malignancy. In addition, TC would have different doppler pattern with pathologic vascularity.
Regarding lipomatous tissue this is also benign and this represent lipoma of the cord which is also common finding in asymptomatic patients. Liposarcoma is extremely rare, it would have different symptoms and sonographic signs. If you want to ease your mind the only more accurate imaging test would be MRI, and you can check seminoma markers as well. However, I dont think this is necessary in your case as no suspicious lesions are found. Wish you good health. Regards
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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