Giant Epididymal Cyst in the Right Testicle: Case Report and Literature Review.
Authors:   Surgery Resident. Clínica Hospital Mérida, ISSSTE. Facultad de Medicina de la Universidad Autónoma de Yucatán., Pinelo Jairo David Villanueva , Echeverría Alexis Emir Noguera ,   Surgery Resident. Clínica Hospital Mérida, ISSSTE. Facultad de Medicina de la Universidad Autónoma de Yucatán., Guerrero María Fernanda Ibarra ,   Pediatrics Resident. Clínica Hospital Mérida, ISSSTE. Facultad de Medicina de la Universidad Autónoma de Yucatán, Ramírez José Manuel Michel ,   Urology Resident. Hospital Regional “Valentín Gómez Farías”, ISSSTE. Universidad de Guadalajara., Hernández Jorge Francisco Martínez ,   Urology Resident. Hospital Regional “Valentín Gómez Farías”, ISSSTE. Universidad de Guadalajara., López Alejandra Soledad Alamilla ,   Social Service MD Intern, Facultad de Medicina de la Universidad Autónoma de Yucatán., Chan María Jocelyn Chan ,   Medical Social Intern. Universidad Anáhuac Mayab., León José Antonio Arjona ,   Family Medicine Doctor. Universidad Autónoma de Yucatán., Zapata Sergio Miguel Polanco ,   MD. Universidad Anáhuac Mayab., González Michel Ernesto Herrera ,   Surgery Resident. Hospital General “Dr. Agustín O´Horán”, Secretaría de Salud. Facultad de Medicina de la Universidad Autónoma de Yucatán., Patiño Gerardo Bracamontes ,   Surgery Resident. Hospital General “Dr. Agustín O´Horán”, Secretaría de Salud. Facultad de Medicina de la Universidad Autónoma de Yucatán., Hernández Romina Solís ,   Medical Intern. Universidad Anáhuac Mayab., Reyes Minerva Jiménez ,   Medical Intern. Universidad Anáhuac Mayab., Huezo Daniel Guitérrez ,   MD. Universidad Anáhuac Mayab., Salazar Pablo Roger Herrera ,   MD. Universidad Anáhuac Mayab., Interián Francisco Javier Martín ,   MD. Universidad Anáhuac Mayab., Dorantes Jesús Omar Chan ,   Emergency Medicine Resident. Hospital General Regional “Licenciado Ignacio García Téllez”, IMSS. Facultad de Medicina de la Universidad Autónoma de Yucatán., Becerra Astrid Arlen Gallegos ,   Anestesiology Resident. Hospital General Zona 14, IMSS. Facultad de Medicina de la Universidad de Guadalajara., Gamboa Dioney Josimar Ucán ,   Surgery Resident. Clínica Hospital Mérida, ISSSTE. Facultad de Medicina de la Universidad Autónoma de Yucatán, Reyes Leonardo Jiménez ,   Medical Student. Universidad Anáhuac Mayab.
Published: November 2024

Introduction: Cystic intratesticular lesions can occur in the second and fourth decades of life and are typically identified via ultrasound. Testicular cysts, usually under 2 cm, result from epididymal-lymphatic obstruction or hormonal changes. Larger lesions with sperm and lymphocytes are spermatoceles. Epididymal cysts are asymptomatic but can cause discomfort or pain, sometimes requiring surgery. Clinical case: A 38-year-old male with no chronic diseases presented with a giant tumor in the right testicle, experiencing pain and hypersensitivity. Physical examination and ultrasound revealed an irregular, painful testicular tumor and a right epididymal cyst. A right epididymal tumor excision was performed successfully. Discussion: Testicular cysts are benign and represent 20-40% of benign testicular tumors. They may arise due to idiopathic, infectious, or traumatic causes with no established risk factors. Diagnosis is often incidental and involves physical examination and imaging techniques like ultrasound. Management is conservative for asymptomatic cases, while symptomatic cases may require surgical intervention that involves careful separation of the cyst from the adhered area. Conclusion: An epididymal cyst is a common pathology in males worldwide, occupying up to 40% of the masses in the testes at the time of a urological assessment. It is a collection at the testicular level of hyaline content and usually measures < 2 cm. They are generally asymptomatic, but when their size exceeds 2 cm or causes symptomatology, it is important to know the therapeutic options that can be offered to patients. In the case of our patient, as it is an epididymal cyst with a diameter of 5 cm and with additional symptomatology, the ideal management was surgical resection, showing adequate evolution in the postoperative follow-up.