Unusually Large Scrotum in a Newborn

Abstract

A term newborn presents with enlarged, bilateral scrotal swelling observed immediately at birth (Fig 1). Figure 1. Bilateral scrotal swelling. ### Prenatal and Birth Histories The patient was born to a 19-year-old gravida 1, para 0 African American mother at 40 weeks’ gestation via spontaneous vaginal delivery in the hospital. Maternal history was notable for previous herpes infection. The patient’s mother received routine prenatal care; findings on serologic and group B Streptococcus testing were negative. ### Presentation Routine ultrasound at 33 weeks’ gestation revealed a fetus with highly echogenic foci clumped in the abdomen and an enlarged scrotum. A magnetic resonance imaging scan at 34 weeks of gestation revealed mild perisplenic ascites and large complex bilateral hydroceles without evidence of a solid mass. He received routine care after delivery and was transferred to the term nursery. ### Physical Examination Physical examination demonstrated all vital signs within normal limits; findings of a complete physical examination were normal except for soft, bilateral scrotal swelling without any palpable nodules or masses. His penis was surrounded by the scrotal swelling and appeared otherwise normal (Fig 1). He was able to urinate, and meconium was passed within the first 24 hours. No abdominal distension or gastrointestinal problems were detected. The differential diagnosis of scrotal mass with or without calcifications at birth includes the following (1): On admission to the newborn nursery, abdominal …