Posts Tagged ‘testes mass’

Nubbins On Your Nuts: What You Should Know About Tunica Cysts

February 9, 2019

Andrew Siegel MD    2/9/2019

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Image of testes and its tunics (covering sheaths) from Gray’s Anatomy (public domain)

The tunica albuginea is the dense fibrous sheath that surrounds, covers and protects the delicate contents of each testicle. The tunica albuginea is surrounded by a second layer, the tunica vaginalis. Benign cystic masses may arise from either tunic.

Cysts originating from the tunica albuginea are the most common benign masses that originate external to the testicle. They are small, firm, irregular, plaque-like nubbins located on the surface of the testes ranging from 2-5 mm in size.  They are often described as feeling like a “grain of rice.” They are most often found  on the upper front or upper side aspect of the testicle. In most cases they are minimally symptomatic and are discovered incidentally by the patient, who is typically around 40 years of age.

These cysts can cause a great deal of concern and worry because of the fear of testes cancer, but they are distinguished from testes cancer by being cystic (not solid) and on the outer surface of the testes as opposed to being within the testes.  Ultrasonography is the imaging study of choice for evaluating testicular masses and can differentiate cystic, benign masses from solid, malignant masses.

On ultrasound the tunica albuginea can be seen as a 2-layered echogenic (containing lots of echoes) structure surrounding the testicle and the cyst as a small, regular fluid-filled structure abutting the surface of the testicle (see below).  On occasion, a tunica cyst may calcify. Microscopically, they are seen to contain fluid and cellular debris.  Although these cysts can be surgically excised, it is only rarely necessary to do so because ultrasound can reliably confirm their benign diagnosis.

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Tunica albuginea cyst on ultrasound
       (cyst is black oval structure)

Wishing you the best of health,

2014-04-23 20:16:29

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States.

Dr. Siegel is the author of 5 books: FINDING YOUR OWN FOUNTAIN OF YOUTH: The Essential Guide to Maximizing Health, Wellness, Fitness and Longevity

PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food

MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health

 and hot off the press is PROSTATE CANCER 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families

Andrew Siegel MD Amazon author page 

 

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