Atypical manifestation of embryonal testicular cancer as a cystic structure: a case report

Intratesticular cysts have recently become a common finding in clinical practice. According to research data, such formations are detected in 8.0 – 9.8% of men. Simple intratesticular cysts do not have malignant potential and do not require monitoring or treatment. However, it is crucial to differentiate them from cystic neoplasms, which may conceal malignant processes. This article presents a clinical case of a 30-year-old patient in whom ultrasonography revealed a cystic formation in the right testis with a minimal solid component measuring 7.1 × 6.9 × 8.5 mm. Initially, active surveillance with regular ultrasound monitoring was chosen. However, progressive enlargement of the lesion required surgical intervention. Given the small size of the tumor, an attempt was made at testis-sparing surgery. However, intraoperative morphological examination using frozen sections revealed the malignant nature of the lesion, leading to the performance of a radical inguinal orchiectomy. The final histological examination confirmed the diagnosis of embryonal carcinoma. This clinical case demonstrates an atypical manifestation of embryonal testicular carcinoma in the form of a predominantly cystic lesion with a minimal solid component. The presented case complements existing data on the ultrasound characteristics of embryonal carcinoma and highlights the importance of careful active surveillance even for small cystic formations in testis.