Congenital dysplasia of the rete testis (CDT) is a rare, benign tumour which affects children. It usually presents with a painless testicular swelling and is often associated with other urogenital anomalies, such as renal agenesis. It was first described in 1973 and a handful of cases have been reported since. In this article, we will describe a patient case and discuss imaging findings, suggested pathophysiology and treatment options.

Case Summary 
We describe the case of a 3-year-old who presented with a non-tender, firm, right-sided testicular swelling. Of note, he had been diagnosed with right renal aplasia in infancy. He underwent an ultrasound of the testes which demonstrated avascular cystic changes centrally within the right testis. The findings were consistent with cystic dysplasia of the right testis, which was associated with ipsilateral renal agenesis. The left testis was entirely normal. Overall, the sonographic appearances were consistent with cystic dysplasia of the right testis, which was associated with ipsilateral renal agenesis.

Images

Figure 1: There were multiple avascular cystic changes in the right testis. The parenchyma of the lower pole was normal

Figure 2: Superior view of the cystic...

...read more

In summary, congenital dysplasia of the rete testis is a benign cause of testicular swelling in children, a presentation which is alarming for malignancy. Ultrasound demonstrates multiple anechoic cysts with normal surrounding testicular parenchyma. There is an association with other urogenital anomalies, most commonly ipsilateral renal agenesis. Treatment options include surgery and surveillance with ultrasound.