Tunica albuginea cyst

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Tunica albuginea (TA) cysts are the most common extratesticular benign scrotal mass lesion. They are a type of scrotal tunica cyst.

Epidemiology

Their mean age at presentation is 40 years (although may be seen in the 5 and 6 decades).

Clinical presentation

They are usually palpable.

Pathology

They arise from the tunica albuginea, a fibrous layer below the tunica vaginalis which closely covers the testicle. The exact pathogenesis of tunica albuginea cysts is not known but it is believed to arise from the mesothelia.

Location

They are characteristically located at the upper anterior or lateral aspect of the testicle.

Radiographic features

Ultrasound

Ultrasound is the first line modality for imaging.

  • typically seen as an anechoic paratesticular cyst
  • usually ~2-5 mm in diameter
  • sharply demarcated
  • unilocular or multilocular
  • no solid components
  • no disturbance of the adjacent testicular tissue
  • rarely calcify
  • occasional milk of calcium or even a complex appearance

Differential diagnosis

On ultrasound consider:

See also