Clin Surg | Volume 1, Issue 1 | Research Article | Open Access

Pathogenic Mechanisms for Spermatocele and Epididymal Cyst Formation

Kathyrn LaRusso1, Jeffery Miller4, Kahlil Saad2 and George F Steinhardt3*

1Department of Surgery, University of Texas Health Center, USA
2Department of Urology, Wayne State University, USA
3Department Urology, Helen DeVos Children's Hospital, USA
4Department of Pathology, Spectrum Health, USA

*Correspondance to: George Steinhardt 

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Introduction: Spermatoceles (SC) and Epididymal Cysts (EC) are commonly diagnosed with the onset of symptoms or more often as incidental sonographic findings. In experimental animals, fetal tissues exposed to estrogen mimetic compounds demonstrate the development of abnormal cystic structures in the epididymis of adult animals. The only known cause of EC in adult humans is fetal exposure to the potent estrogen diethylstilbestrol (DES). Additionally, previous studies have also shown that Estrogen Receptor knockout (ERKO) mice demonstrate disruption of luminal fluid resorption in the efferent ducts in the head of the epididymis which is the usual anatomic location for both SC and EC. This study investigates the possible association of undue estrogen stimulation and the occurrence of spermatoceles (SC) and epididymal cysts (EC) by analyzing human SC and EC tissue for the estrogen inducible protein lactoferrin (LF) as well as estrogen receptor 1 (ESR1) and estrogen receptor 2 (ESR2).Methods: An IRB approved study identified 10 patients with well-documented SC and 7 patients with EC between the years 2007-2012. Formalin fixed paraffin embedded blocks of surgically removed tissue were stained using immunohistochemistry (IHC) for lactoferrin (LF), estrogen receptor1 (ESR1) and estrogen receptor 2 (ESR2).Results: Both ECs and SCs stained positive for LF, ER1 and ER2. Results are summarized in the table below.Conclusion: IHC staining for LR, ER1, and ER2 suggests estrogen stimulation and disruption as a possible pathogenesis of both EC and SC.


Spermatocele, Epididymal Cyst; ESR


LaRusso K, Miller J, Saad K, Steinhardt GF. Pathogenic Mechanisms for Spermatocele and Epididymal Cyst Formation. Clin Surg. 2016; 1: 1261.

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