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).