Cysts of the Tunica Albuginea. Report of 4 Cases and Review of the Literature

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Abstract
Four cases of benign testicular cysts arising from the tunica albuginea are reported. A review of the literature yielded only 4 more instances of such lesions. Clinically, these cysts may be manifested as a tumor or painful swelling, or are discovered incidentally. In 3 cases a diagnosis of testicular carcinoma was entertained and high inguinal orchiectomies were done. The possibility of a conservative surgical approach, as followed in 1 case, is discussed. These cysts appear in the anterior and lateral aspects of the testis, show ample connection to the albuginea and are lined by a cuboidal epithelium. Gland-like inclusion were found in the fibrous cystic walls and in the albuginea. The histogenesis of these lesions is discussed and evidence for a possible origin in mesothelial rests trapped during development is presented. The differential diagnosis of cystic lesion of the tests is reviewd briefly.