Cystic dysplasia of the rete testis in a young adult accompanying ipsilateral renal agenesis: A case report

Abstract

Abstract Background: A 31-year-old man was referred from an outside institution to the department of urology under the suspicion of a testicular tumor, with left-sided testicular pain lasting a couple of months in duration. Physical examination showed a hard, thickened and small left testis on palpation with diffuse, inhomogeneous ultrasonographic appearance. After urologic examination a left-sided inguinal orchiectomy was performed. The testis, epididymis and spermatic cord were sent to pathology. Case presentation: On gross examination, a cystic cavity filled with brown fluid content and surrounding brownish parenchyma measuring up to 3.5 cm in diameter was found. Histologic examination showed cystically dilated rete testis lined with cuboidal epithelium and a positive immunohistochemical reaction to cytokeratins. The cystic cavity was microscopically a pseudocyst filled with extravasated erythrocytes and abundant clusters of siderophages. The siderophages extended into the testicular parenchyma, surrounding the seminiferous tubules and spreading out around ducts of the epididymis, which were also cystically dilated with siderophages inside their lumina. Conclusions: On the basis of clinical data, histological and immunohistochemical analysis, a diagnosis of cystic dysplasia of the rete testis was established. According to the literature there is a very well-known association between cystic dysplasia of rete testis and ipsilateral genitourinary anomalies. The patient was referred to the department of radiology, and a multi-slice computed tomography scan revealed ipsilateral renal agenesis, right seminal vesicle cyst reaching up to the iliac arteries and a multi-cystic formation cranial to the prostate.