Radiologic findings of a giant unilateral abdominoscrotal hydrocele associated with undescended testis

Abstract

Abdominoscrotal hydrocele (ASH) is an uncommon entity characterized by an hourglass-shaped hydrocele that extends from the scrotum into the abdominal cavity. In this case, ultrasonography and computed tomography findings of an 11-month-old patient with a right ASH and undescended testis are reported.

Abdominoscrotal Hydrocele With Intra-abdominal Undescended Testis in an Elderly: A Case Report

“…The incidence of coexisting UDT with ASH seems to be underestimated but shows a marked pediatric predominance. In this setting, the most common location is inguinal but rarely intra-abdominal [ 6 , 7 ]. The current case describes an aged man with late development of ASH, whereupon a neglected intra-abdominal UDT was found within the abdominal sac.…”

“…The intercommunication between the two cystic compartments can be confirmed radiologically by ultrasound evaluation [ 1 - 5 ]. However, if USG is inconclusive or when complications are suspected, CT and MRI may be useful to better assess the abdominal cyst and its effect on surrounding tissues, as well as testis structural features [ 2 , 7 ]. They may also be helpful in unclear cases or disrupted anatomy, as in this case with unexpected clinical suspect of ASH in the setting of neglected ipsilateral cryptorchidism.…”

“…Moreover, our patient who presented with an intra-scrotal displacement of a clinically unnoticed retroperitoneal hydrocele could have been misdiagnosed as indirect inguinal hernia, which is the most common differential diagnosis in such clinical scenario [ 4 - 5 , 7 ]. Furthermore, in a patient presenting with inguinoscrotal swelling and neglected cryptorchidism, a germ cell tumor must also be considered.…”

“…Furthermore, in a patient presenting with inguinoscrotal swelling and neglected cryptorchidism, a germ cell tumor must also be considered. Other differential diagnoses include spermatic cord lymphangioma, abdominoscrotal spermatocele, giant hydronephrosis extending into the true pelvis, bladder diverticulum, and pelvic neuroblastoma [ 5 , 7 ].…”