Testicular cysts
- On 28/10/2025
What is a testicular cyst?
A testicular cyst is a benign testicular growth that is not caused and almost never develops into cancer. Cysts are lesions that can develop in many places in the body, both in an organ and in a tissue.
Several types of cysts can develop in the testicles in men:
- the benign teratoma, which is a type of tumor that often develops before puberty and very often in babies;
- the lipoma is a tumor made up of fat cells. It can appear anywhere in the body and therefore in the testicles;
- the epididymal cyst or spermatocele is a fluid-filled cyst that develops in the epididymis. The epididymis is a coiled tubular structure that stores and transports sperm;
- the hydrocele is a fluid-filled sac that forms around the testicle. Generally painless, it often disappears on its own;
- the epidermoid cyst is a very rare benign tumor that accounts for only 1 to 2% of all testicular masses. Very often, patients experience no clinical signs.
We also find diseases in the testicles that are not cysts but can cause swelling and give the impression of a cyst. This includes:
- epididymitis, which is an inflammation of the epididymis that can become inflamed and swollen;
- orchitis, which is a bacterial or viral infection of the testicle. It is painful and can cause swelling;
- varicocele, which is an enlargement of the veins inside the testicle.
It is essential to emphasize the distinction between a tumor and cancer: benign tumors grow locally without affecting the surrounding tissues. Cancers, or malignant tumors, spread by destroying surrounding tissues. It frequently happens that they can spread to other parts of the body and cause metastases.
What are the causes?
We do not know the precise reasons for the appearance of an epidermoid cyst in the testicle. However, for other cysts located in the testicle, there are some possible explanations. For example, an epididymal cyst can form following a vasectomy, a male sterilization operation that involves cutting the vas deferens.
Other causes can be considered, such as testicular torsion, which is the twisting of the spermatic cord. This torsion causes severe pain and is an emergency.
What are the symptoms of a testicular cyst?
Most of the time, an epidermoid cyst does not cause any symptoms in the affected person. It will be discovered incidentally during another medical examination. In rare cases, it can, however, cause an increase in the volume of the scrotum.
Regarding the spermatocele or epididymal cyst, the patient will notice an increase in the volume of the scrotum. Some men affected by this disease describe a feeling of fatty mass in the scrotal region. This size can also cause localized discomfort for the patient.
Clinical diagnosis
The diagnosis begins with a medical examination:
Interrogation
The doctor asks questions about:
the pain (often absent or mild),
the discomfort or heaviness in the scrotum,
the duration of the mass's appearance,
and medical history (traumas, infections...).
Physical examination
The doctor palpates the testicles:
A cyst presents as a smooth, soft or firm, mobile ball, separate from the testicle.
It is often painless.
By transillumination (by placing a lamp behind the scrotum), the light passes thru, indicating that it is a liquid content.
Additional tests
To confirm the diagnosis:
Testicular ultrasound
It's the key exam.
It allows:
visualize the cyst (pocket filled with clear liquid),
determine its size and location,
exclude a testicular tumor (more serious).
Other tests (if in doubt)
Blood tests (tumor markers: AFP, β-hCG) → to rule out cancer.
Urine analysis if associated infection is suspected.
What are the possible treatments?
When cysts are identified, clinical observation is generally considered first. It is common for an ultrasound to confirm the absence of particular risk. However, if this cyst develops too quickly or if this growth is massive, surgery is suggested. We also propose surgery to remove the cyst for the patient if it does not show significant growth, however, if the cyst causes specific discomfort or potential pain, such a procedure is considered.
In extreme and fortunately rare cases, particularly in the presence of epidermoid cysts, surgical removal of the testicle affected by the cysts is also considered. This is a procedure called orchiectomy.