2023 Volume 50 Issue 3 Pages 205-210
Papillary cystadenoma of the epididymis (PCE) is a rare benign tumor of the epididymis. It occurs in association with von Hippel-Lindau disease (VHLD), an autosomal manifestation of the disease, and also occurs solitarily. However, there have been few imaging reports, and in the absence of a history of VHLD, a preoperative diagnosis is difficult. As such, orchiectomy is often performed. In this report, we describe a case of PCE that was thought to be solitary, focusing on ultrasound images. The patient was a man in his 70s. A mass with hypervascularity was incidentally detected in the left scrotum on contrast-enhanced computed tomography (CT), suggesting a right inguinal hernia. On ultrasonography, the mass was located adjacent to the cephalic side of the left testis, with clear boundaries in B-mode, and the interior was isoechoic to the testis, with a high echo area with acoustic shadows that appeared to be calcification. Color Doppler showed abundant color in most of the mass, and although PCE was considered as a possible diagnosis, a primary sarcoma in the paratesticular area could not be ruled out, and high orchiectomy was performed. Histopathologically, the tumor was a papillary growth of cells with pale cytoplasm and chromatin-enhanced, similarly round or slightly distorted nuclei. The possibility of metastasis from clear cell renal cell carcinoma and PCE was considered. Ultimately, PCE was clinically diagnosed due to absence of a history of renal cell carcinoma.
