Cystic Dysplasia of the Rete Testis: Does Pathophysiology Guide Management?

Cystic dysplasia of the rete testis (CDT) is a rare, benign, cause of testicular mass in the pediatric population. The mass appears on sonography as multiple small cysts of varying size surrounded by normal or compressed testicular tissue. CDT is often associated with other genitourinary anomalies, commonly presenting with agenesis or dysplasia of the ipsilateral kidney. The pathophysiology and the management remains controversial. We report a case of a 3-year-old presenting with an enlarged testicular mass later presumed to be CDT associated with ipsilateral renal agenesis, review the literature, and propose an evaluation and management algorithm.

Polyorchidism and adenomatous hyperplasia of the rete testis: a case report with sonographic and magnetic resonance imaging findings and review of literature.

Supernumerary testis or polyorchidism is a rare congenital anomaly with about 200 reported cases in the literature. It may be associated with cryptorchidism, testicular torsion and neoplasms. Ultrasonography and magnetic resonance imaging are effective noninvasive methods of accurately detecting polyorchidism. In most cases, ultrasonography is diagnostic and magnetic resonance imaging plays confirmatory role by providing additional information if complicated with neoplasia. We report a case of 16-year-old man with right supernumerary testis associated with adenomatous hyperplasia of the rete testis, its sonographic and magnetic resonance imaging findings and management.

Cystic dysplasia of the rete testis: ultrasound and magnetic resonance imaging findings.

Cystic dysplasia of the testis is a rare congenital anomaly. It presents a diagnostic challenge to the pediatrician and should be distinguished from malignant lesions. We herewith present a two-month-old boy who presented with right inguinal swelling. Detailed investigations including ultrasound and magnetic resonance imaging helped in establishing the diagnosis of cystic dysplasia. To the best of our knowledge, our case is the first case of cystic dysplasia of the rete testis in the literature, which presented as undescended testis (inguinal swelling), with no associated renal or ureteric anomalies.

Cystic dysplasia of the rete testis.

Cystic dysplasia of the rete testis (CDT) represents a diagnostically challenging condition in the pediatric population. We report a new case of CDT that differs in presentation from the majority of other cases in the literature in that the child complained of scrotal pain and had a solid mass on ultrasound. Based on this experience and a review of the literature, we recommend including CDT in the differential for all pediatric scrotal masses regardless of whether the mass is painless or painful, cystic or solid. As CDT is a benign lesion, we propose an individualized treatment of CDT.

A unique radiological pentad of mesonephric duct abnormalities in a young man presenting with testicular swelling.

Cystic dysplasia of the rete testis with associated ipsilateral renal agenesis is a very rare congenital abnormality, mainly described in the paediatric literature. In addition, the presence of a seminal vesicle cyst with ipsilateral renal agenesis is a rare but well-described entity. We present an adult who was found to have a unique pentad of mesonephric duct abnormalities on radiological imaging, including cystic dysplasia of the rete testis, seminal vesicle cyst, ipsilateral renal agenesis, partial hemitrigonal development and epididymal dilatation. We review and discuss the relevant literature of this case and discuss in detail the embryological basis for this unusual combination of findings.

[Cystic dysplasia of rete testis associated with ipsilateral renal agenesis. Case report]. / Displasia cistica della rete testis associata ad agenesia renale omolaterale. Descrizione di un caso clinico.

Cystic dysplasia of the rete testis is a rare abnormality often associated with the ipsilateral agenesis of kidney. This malformation is due to a development defect of the mesonephric duct which is the cause of both the dilation of the testicular rete testis and renal agenesis. A case of this rare malformation, showing all the peculiarities described in the medical literature, is presented. A 3 years-4 months boy was examined for an asymptomatic left scrotal mass; thus, he underwent ultrasonography, which showed a multiple tubular and cystic dilatation of left rete testis, associated with the absence of left kidney, afterward confirmed by MAG3-radionuclide scan. Diagnosis was also validated by testicular biopsy. No surgery was required. The child is nowadays under observation and at 2-years follow-up he doesn't show any symptom. According to many authors, a conservative treatment of this benign congenital abnormality is suggested as well as serial ultrasonography to monitor the growth of the testicular mass, which in a longest follow-up, could require surgery. Malignant transformation nor infertility have never been described.

Cystic dysplasia of the rete testis: report of two cases and review of the literature.

Cystic dysplasia of the rete testis (CDT) is a rare congenital defect, characterized by multiple irregular cystic spaces in the mediastinum of the testis that may involve the whole gonad. A review of the literature has shown 32 reported cases, the majority of which were associated with ipsilateral renal malformations (agenesis/cystic dysplasia). Pathogenesis may be attributed to an early insult involving mesonephric duct development. Although treatment is surgical, when feasible, a conservative or nonoperative approach is suggested. Here we report two cases, one in a 3-year-old boy and one in a 10-day-old newborn. Concomitant cystic dysplasia of ipsilateral kidney was present in the former patient, while CDT was the solitary finding in the latter patient. Orchiectomy was performed in both patients, for extensive gonad involvement in the older boy and for suspected gonad torsion in the newborn patient.

Congenital cystic dysplasia of the rete testis.

Cystic dysplasia of the rete testis (the network of straight seminiferous tubules within the mediastinum testis leading to the efferent ductules) is a rare congenital anomaly. There are only 15 cases reported in the literature to date and only one report of the US findings [1-5]. This report highlights the characteristic appearance of the lesion on ultrasound examination and its association with renal abnormalities in two patients.

Ultrasonography revealing the accumulation of rete testis fluid in bull testicles.

Ultrasonography was used for diagnosing accumulation of rete testis fluid in live bulls. When 447 bulls of Ayrshire breed selected for artificial insemination were studied by ultrasonography, eleven were detected in which the ultrasonograms visualized accumulation of rete testis fluid in the testicles. In 7 bulls the accumulation (spermiostasis) was bilateral and in 4 unilateral. In only four out of 18 testicles, macroscopically epididymal cysts were seen after slaughter. At the age of 16 months four bulls with bilateral spermiostasis were azoospermic. When studied by ultrasonography, the rete testis of normal testicles was echogenic and narrow but in affected testicles anechogenic and wide. Nine of the affected bulls were sons of three fathers. We suggest that spermiostasis is hereditary in Ayrshire bulls and, as in the goat, is progressive by nature.