Abstract
Bilateral scrotal masses may present as polyorchidism or benign neoplasms. Epidermoid cysts (ECs) are common benign cutaneous lesions that are characterized by encapsulated sebaceous cysts containing keratin. These cysts can undergo complications such as ruptures, infections, or daughter cyst formation. A 29-year-old male presented with an asymptomatic scrotal mass. On physical examination, intrascrotal masses were palpated superior to each testis. An ultrasonographic evaluation revealed that the two masses were discrete and located superior to the right and left testis, respectively. The parenchymal echogenicity of these lesions was comparable to that of normal testicular parenchyma. Under the clinical impression of benign scrotal lesions, the provisional diagnosis was of bilateral testicular masses due to polyorchidism. Surgical intervention involved the complete excision of both masses. The subsequent histopathological examination revealed the definitive diagnosis of ECs. This case illustrates that despite the advantages of Doppler imaging, ultrasonography may yield less accurate results than histopathological findings.