Residency Program - Case of the Month

Clinical history:

The patient is a 62-year-old male, with no significant past medical history, who presented with a chief complaint of a lump in his right testicle causing mild discomfort. Physical exam revealed a well-circumscribed 1.0 cm mass in the posterior aspect of his right testicle. The mass was mildly tender to palpation. A scrotal ultrasound revealed 1.2 x 1.1 x 1.0 cm solid heterogenous vascular mass adjacent to the right epididymal head.  The mass remained stable on subsequent q 3-6 month serial ultrasound examinations, however, due to continued mild testicular pain, the patient elected to undergo surgical excision of the mass.

Gross description:

The specimen consisted of rubbery tan segment of soft tissue, measuring 1.4 x 1.2 x 1.0 cm. Sectioning of the specimen revealed a cystic structure filled with yellow-tan to red-brown cystic material. The cyst wall measured up to 0.1 cm in maximal thickness.

Microscopic photographs:

ANSWER