Post-Pubertal Teratoma of the Testis Masquerading as a Cystadenoma in a Young Male: Is High Inguinal Orchidectomy the Way to Go?

Postpubertal teratoma of the testis is a nonseminomatous germ cell tumor (NSGCT) composed of mature and/or immature tissues derived from all three germ layers (ectoderm, mesoderm, and endoderm). Unlike prepubertal teratomas, which are benign, postpubertal teratomas are malignant with a high risk of metastasis. We report a case of a post-pubertal testicular teratoma in a young male initially misdiagnosed as a benign cystadenoma on imaging. Despite radiologic ambiguity, high inguinal orchidectomy was performed, revealing a mature teratoma with malignant potential. This case highlights the diagnostic challenges of testicular masses and reinforces the role of high inguinal orchidectomy as the definitive diagnostic and therapeutic approach, particularly in lesions with uncertain malignant potential in post-pubertal patients.