The differential diagnosis for extratesticular cystic lesions includes:
- hydrocele
- epididymal cyst
- spermatocele
- hematoma
- hematocele
- loop of bowel from an inguinal hernia
- abscess
- pyocele
- post-vasectomy
- varicocele
Very rarely, a scrotal mesothelioma may present as a cystic mass.