Case history:
A one-year-old boy was brought by his parents to the urology departement with a complaint of right testicular enlargement(fig.1).on physical examination, He looks healthy, had no surgical, trauma history. The left testis and epididymis were normal.Scrotal ultrasound exposed a 2 cm simple testicular cyst(Video 1).Due to the low incidence of simple testicular cysts in infants and the sensitivity of testiculectomy and its psychological consequences especially at this age so we did an aspiration to the cyst through the scrotum under ultrasound guidance. The aspiration was clear serum like 2ml fluid. The simple testicular cyst disappeared later, and with follow-up for months, no enlargement of the right testicle or recurrence of the simple testicular cyst was observed during this period. In the first year of following up everything was normal. After two years,the boy was brought to the department again because of the recurrence of the testicular enlargement. Differential diagnosis, investigations and treatment:
Physical examination shows a 1 cm in diameter solid irregular mass in his right testis, as well as in ultrasonography(fig.2).Tumor markers show normal beta-HCG, but alpha-fetoprotein higher than 1200ng/ml. Surgical inguinal exploration
was performed because the non-malignant part of the testicle does not exceed 5% of the entire testicle . Frosen section revealed Teratoma, so we did radical orchiectomy(fig.3A). The biopsy showed cystic formations with
multilayered and keratinized epithelium, and beneath this epithelium
there are glandular formations, which confirms the diagnosis of Mature Cystic
teratoma 1 cm not invading tunica albuginea(fig.3B).