A single-stage reconstruction on giant scrotal lymphedema: a case report

Abstract

Introduction: Scrotal lymphedema is a rare condition characterized by the swelling of the scrotal skin due to deterioration in lymphatic drainage. Although not life-threatening, chronic lymphedema is disabling with significant physical and psychological morbidity and complications, including impaired hygiene, urinary incontinence and immobility. This report aimed to describe the diagnosis and treatment of giant scrotal lymphedema. Case Presentation: A 23-year-old man presented with a gradually enlarging scrotum. Physical examination of the genitalia shows that the patient’s penis was difficult to identify, and testes were completely impalpable due to the thickness of the scrotal skin. There were neither inguinal lymph node enlargement nor other skin lesions on the scrotum. The scrotum was homogenous, with a measured dimension of 35 cm x 28 cm x 20 cm anterior to posterior. Laboratory evaluation, including complete blood count, complete metabolic panel, human immunodeficiency virus, sedimentation rate, and antibodies to strongyloides, schistosomes, and filaria, were within normal limits. The penis and testes were normal-sized and clearly demarcated from computed tomography scan, buried within the hardened scrotal soft tissues, with no signs of testicular tumor or any pelvic lymph node enlargement. Conclusion: Scrotal lymphedema is a rare condition characterized by the swelling of the scrotal skin due to deterioration in lymphatic drainage.