Spermatic cord hydrocele

Case contributed by Dr Nikos Karapasias

Presentation

Male patient with sweling, erythema and tenderness of the left hemiscrotum. The patient reports a painless swelling of the left hemiscrotum for 6 years. Clinical examination: ovoid, smooth, painless, mobile irreducible swelling, transparent to the incident light.

Patient Data

Age: 65
Gender: Male
Ultrasound

Left testis & epididymis are normal in echogenicity, without any fluid in the scrotal sac.

US image of the left scrotum shows an anechoic fluid collection superior & lateral to the left testicle, with no internal solid components. No evidence of bowel loop is seen in the fluid collection, which is clearly separated from the scrotal sac. Vascularity is absent in the fluid collection.

Pathology
Large fluid filled membranous sac.

Case Discussion

Spermatic cord hydrocele is a collection of fluid along the spermatic cord that lies superior to the testicle and does not communicate with the scrotal sac. It is a rare congenital anomaly resulting from abnormal closure of the processus vaginalis. If the fluid collection persist after closure of processus vagianalis,  resulting a hydrocele of cord (hydrocele of canal of Nuck in females) or a non-communicating hydrocele.

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Case information

rID: 25399
Case created: 23rd Oct 2013
Last edited: 1st Nov 2016
System: Urogenital
Inclusion in quiz mode: Included

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