![]() ![]() One year later, testicular ultrasound was repeated, and the lesion exhibited the same morphological characteristics, with no internal blood flow, although its dimensions increased to 33 × 12 × 27 mm.Īt the last follow-up-−28 months after surgery-the patient was in good general condition. Four months after surgery, testicular ultrasound revealed no change in the right testicular lesion. Histological examination, along with renal agenesis, confirmed the diagnosis of CDRT. No germ cell tumors were identified ( Figure 2). The cysts were lined with flattened cuboidal epithelium and separated by fibrous septa. Histological examination revealed irregular cystic spaces located in the mediastinum of the testis, displacing the testicular parenchyma. Intraoperatively, the testicular parenchyma was mostly substituted with spongiform tissue accordingly, biopsy of the right testicle and epididymis was performed. ![]() Surgical exploration was performed using the inguinal approach to exclude possible malignancy. ![]() ![]() Testicular ultrasound performed on the lesion 3 and 5 months later revealed no variations in morphology, size, or structural characteristics. The patient was followed-up with periodic clinical and ultrasonographic examinations. Considering the ultrasound characteristics of the lesion associated with renal agenesis, CDRT was suspected, and a conservative treatment strategy was chosen. Markers for testicular tumors, including alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase, were within normal limits. Moreover, MRI confirmed right renal agenesis and revealed enlargement of the right epididymis with an extended area of altered signal (16.5 × 9.5 × 12 mm), hypointensity on T1, and hyperintensity on diffusion-weight imaging sequences, with no contrast uptake and without calcific or fat images. The right kidney was not visualized on abdominal ultrasound, which suggested right renal agenesis, whereas the left kidney and bladder appeared to be normal. Screening for associated urinary anomalies was performed using abdominal ultrasound and magnetic resonance imaging (MRI). The lesion did not appear vascularised on color Doppler ultrasound and was surrounded by normal testicular parenchyma in addition, the left testicle was normal. Testicular ultrasound examination was repeated, revealing a circumscribed area, measuring 20 × 10 × 9 mm, containing several minuscule cysts of varying sizes in the right mediastinal testis ( Figure 1). The right testicle exhibited a palpable upper pole lesion. On physical examination, the testicles were in the scrotum, with normal volume and consistency. Case ReportĪ 9-year-old boy with a right retractile testicle underwent testicular ultrasonography, which revealed a testicular lesion and, accordingly, was referred to the authors' hospital. Furthermore, we performed a systematic review of the literature to better understand this pathology to design the most appropriate treatment and follow-up strategy for patients with CDRT. The purpose of this study was to investigate CDRT in a 9-year-old boy with a right testicular lesion and ipsilateral renal agenesis. This malformation is likely the result of a disorder(s) in the connection between the mesonephric duct and germinal epithelium and represents a diagnostically challenging condition in the pediatric population ( 1). It is often associated with genitourinary tract anomalies, primarily with renal agenesis ( 3). CDRT is characterized by irregular cystic spaces lined by cuboidal epithelium in the mediastinum or rete testes ( 2). It was first described by Leissring and Oppenheimer in 1973 as a rare benign testicular lesion ( 1). In addition, a systematic review of the literature was performed to better understand this pathology to design the most appropriate treatment and follow-up strategy for patients with CDRT.Ĭystic dysplasia of the rete testis (CDRT) is a rare cause of testicular masses in children. A case involving a 9-year-old boy with a testicular lesion and ipsilateral renal agenesis, who was diagnosed with CDRT after histological examination, is reported. It is often associated with other genitourinary anomalies, commonly presenting as agenesis or dysplasia of the ipsilateral kidney. The pathogenesis of this malformation remains unclear.
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