International Journal of Collaborative Research on Internal Medicine & Public Health

Clinical Presentation

A 10 year old male child presented with gradually progressive swelling in right scrotum, on and off pain in it since 8 month. There was no history of trauma to scrotum/fever/ pyuria/pain in abdomen. Examination reveal approximate 1 cm × 1 cm Trans illuminate, non-reducible, cystic mass in right spermatic cord just above testis. Ultrasonography showed cystic mass behind and above testis. Surgical exploration was done as child was symptomatic, there was 1 cm × 8 mm size cystic mass attached with head of epididymis (Figures 1 and 2). Complete excision of mass was done. Biopsy reveals Spermatocele.

Figure 1: Cystic mass (blue arrow) attached with head of epididymis.

Figure 2: Post of specimen of cystic mass.

Spermatocele (epididymal cyst) in children is uncommon cause of scrotal swelling [1]. Usual treatment is conservative with serial follow up [2-4]. Surgical excision should be considered when Spermatocele is symptomatic, not involuting with time or has developed complication like torsion [2-4].

References

1. Ameli M., Boroumand-Noughabi S., Gholami-Mahtaj L. A 14-Year-Old Boy with Torsion of theEpididymal Cyst. Case Rep Urol 2015;2015:731987.
2. Niedzielski J., Miodek M., Krakós M. Epididymal cysts in childhood-conservative or surgical approach? Pol PrzeglChir 2012; 84:406-410.
3. Sempere FS., Hinarejos C., Durbá A.,Moragues F.,Verduch M., et al. Epididymal cysts in childhood. Arch EspUrol 2005; 58:325-328.
4. Erikci V., Hoşgör M., Aksoy N., Okur Ö., Yildiz M., et al. Management of epididymal cysts in childhood. J PediatrSurg 2013 ; 48:2153-2156.