ClinicResearch Article | DOI: https://doi.org/10.31579/2834-8745/008
A Rare Case Report of Torsion of Huge Epididymal Cyst from Tertiary Hospital
*Corresponding Author: Manojit Sarkar, Dept of General Surgerynrs Medical College & Hospital138, Ajc Bose Road, Kolkata-14,India.
Citation: Manojit Sarkar, (2023), A Rare Case Report of Torsion of Huge Epididymal Cyst From Tertiary Hospital, Journal of Scientific Research and Biomedical Informatics, 2(5); DOI: 10.31579/2834-8745/008
Copyright: © 2023, Manojit Sarkar. This is an open-access artic le distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 11 September 2023 | Accepted: 25 September 2023 | Published: 10 October 2023
Keywords: epididymal cyst; transillumination; management
Abstract
Epididymal Cyst (EC) are benign benign lesion. It arises due to cystic degeneration of the epididymis. The torsion of it is extremely rare. The usual presentation of the cyst is asymptomatic scrotal swelling. The swelling has a lobulated surface & feels like a bunch of grapes. The huge epididymal cyst is rare & moreover it is associated with torsion-rarest presentation.
Case Report
A 46 yr old male patient presented with acute scrotal pain with huge swelling in emergency. The swelling was gradually progressive and painless. But there is sudden onset of of excruciating pain & patient came to emergency.
Discussion
Epididymal cyst are benign benign lesion. It arises due to cystic degeneration of the epididymis. The torsion of it is extremely rare. The usual presentation of the cyst is asymptomatic scrotal swelling. The swelling has a lobulated surface & feels like a bunch of grapes. The huge epididymal cyst is rare & moreover it is associated with torsion. The patient presented with acute scrotal pain in emergency.
Emergency ultrasound Color Doppler scrotum shows testis normal(B/L) with homogeneous arterial perfusion, 15*8 cm well defined wall with few internal echos pushing right testis towards the left. & with many septations without internal vascularity. we are planning it for emergency exploration as the pain was not subsided even after medication.
During the operation, both the testes found normal. A huge cyst found within caput epididymis Torsed 360 degree anti-clockwise on it’s own pedicel. Detorsion followed by excision of the cyst. Post op Transillumination test done and it is brilliantly transilluminant. On aspiration crystal clear fluid comes out. The Histopathological diagnosis was EC with no necrosis in the cells of epididymal duct. The patient was discharged on 3rd post operative day & post operative period was uneventful.
Figure 1: USG SCROTUM shows a huge Figure 2: Intra operative pic of the cyst epididymal cyst
References
- Finkelstein MS, HK, Snyder HM 3rd, et al. (1986).Ultrasound evaluation of scrotum in pediatrics. Urology 27: 1-9.
View at Publisher | View at Google Scholar - Rifkin MD, Kurt AB, Goldberg BB. (1984).Epididymis examined by ultrasound. Correlation with pathology. Radiology, 151: 187-190.
View at Publisher | View at Google Scholar - Gill WB, Schumacher GF, Bibbo M, et al. (1979). Association of diethylstilbestrol exposure in utero with cryptorchidism, testicular hypoplasia and semen abnormalities. J Urol; 122: 36-39.
View at Publisher | View at Google Scholar - Gill WB, Schumacher GF, Bibbo M. (1977). Pathological semen and anatomical abnormalities of the genital tract in human male subjects exposed to diethylstilbestrol in utero. J Urol; 117:477-480.
View at Publisher | View at Google Scholar - Atanassova N, McKinnell C, Turner KJ, et al. (2000). Comparative effects of neonatal exposure of male rats to potent and weak (environmental) estrogens on spermatogenesis at puberty and the relationship to adult testis size and fertility: evidence for stimulatory effects of low estrogen levels. Endocrinology 141: 3898-3907.
View at Publisher | View at Google Scholar - Bibbo M, Al-Naqeeb M, Baccerini I, et al. (1975). Follow-up study of male and female offspring of DES-related mothers. A preliminary report. J Reprod Med; 15: 29-32.
View at Publisher | View at Google Scholar - Jones LA. (1980). Long-term effects of neonatal administration of estrogen and progesterone, alone or in combination, on male BALB/c and BALB/cfC3H mice (40927). Proc Soc Exp Biol Med; 165: 17-25.
View at Publisher | View at Google Scholar - McLachlan JA. (1977). Prenatal exposure to diethylstilbestrol in mice: toxicological studies. J Toxicol Environ Health; 2: 527-537.
View at Publisher | View at Google Scholar - Homayoon K, Suhre CD, Steinhardt GF. (2004). Epididymal cysts in children: natural history. J Urol; 171: 1274-1276.
View at Publisher | View at Google Scholar - Torsion of an Epididymal Cyst 661 10. Chillon SF, Dominguez HC, Serrano DA, et al. (2005). Epididymal cysts in childhood. Arch Esp Urol; 58: 325-328.
View at Publisher | View at Google Scholar - Sidler D, Brown RA, Millar AJ, et al. (1997). A 25-year review of the acute scrotum in children. S Afr Med J; 87: 1696-1698.
View at Publisher | View at Google Scholar - Kaddish HA, Bolte RG. (1998). A retrospective review of pediatric patients with epididymitis, testicular torsion and torsion of testicular appendages. Pediatrics; 102:73-76.
View at Publisher | View at Google Scholar - Lewis AG, Bukowski TP, Jarvis PD, et al. (1995). Evaluation of acute scrotum in the emergency department. J Pediatr Surg; 30: 277-282.
View at Publisher | View at Google Scholar - Steinhardt GF. Editorial comment to epididymal cysts: not always a benign condition. Int J Urol Sep 21, 2012;
View at Publisher | View at Google Scholar - Kaye RI, Cromie WJ. (1990). Torsion of a spermatocele: a case report and review of the literature. J Urol; 143: 786.
View at Publisher | View at Google Scholar - Liolios N, Anagnostopoulos D, Sinopidis X, et al. (1997).Torsion of spermatocele and aplasia of the vas deferens. A case report. Eur J Pediatr Surg; 7: 118-119.
View at Publisher | View at Google Scholar - Yılmaz E, Batislam E, Bozdogan O, et al. (2004). Torsion of an epididymal cyst. Int J Urol; 11:182-183
View at Publisher | View at Google Scholar
