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epididymal cysts
Monday 4 January 2010
Acquired epididymal cysts
Most epididymal cysts occur later in life and are likely acquired. They occur after childhood and are diagnosed by ultrasound examination following palpation of a scrotal mass.
Acquired epididymal cysts usually regress spontaneously, and anatomic pathological studies are rarely performed.
A well-characterized example of acquired epididymal cysts results from obstruction of the epididymis or vas deferens leading to secondary cystic dilation of the epididymal duct, also referred to as spermatocele.
An obstructive mechanism may be also responsible for the development of epididymal cysts in men with history of exposure to diethylstilbestrol (DES-associated epididymal cysts), also detected later in life, and in younger patients with cystic fibrosis due to thickened secretions (ccystic fibrosis-associated epididymal cysts).
VHL-associated epididymal cysts
In patients with von Hippel-Lindau disease (VHL), epididymal cysts are
characteristically limited to the efferent ductules.
VHL-associated epididymal cysts have a peculiar morphology with predominance of clear cells, and often evolve into cystadenomas. They are usually diagnosed in adult patients, with no evidence of congenital lesions.
The occurrence of congenital epididymal malformations with a cystic component has not been fully explored.
Epididymal cysts have been reported in association with seminal vesicle cysts in
adult patients with autosomal dominant polycystic kidney disease (ADPKD), and also in patients with seminal vesicle cysts and ipsilateral renal agenesis.
In most cases, these cysts were diagnosed radiologically with no
pathological documentation, and are likely to be secondary to distal obstruction of
the excretory duct; importantly, these associations have not been reported on
fetuses or young children.
Nota bene: Cystic epididymal and testicular appendices (cystic paratesticular embryonal remnants) which are not connected to the male excretory system should not be considered under this category.
See also
Epididymis
epididymal anomalies
epididymal lesions
