SCROTAL CYSTIC LYMPHANGIOMA - THE MISDIAGNOSED SCROTAL MASS

Purpose: We report 7 cases of scrotal cystic lymphangioma and review t he literature on this unusual lesion, which is often misdiagnosed as o ther conditions and treated incorrectly. Materials and Methods: We ret rospectively reviewed the medical records of 7 patients with scrotal c ystic lymphangioma treated from 1984 to 1996 at 5 institutions. Result s: Mean patient age at presentation was 3 years and painless scrotal s welling was the most common symptom. Physical examination demonstrated an unusual cystic scrotal mass with a normal testis and cord in most patients, and ultrasound in 4 showed a complex septated cystic mass. P reoperative misdiagnosis in all 7 patients included hernia, hydrocele, hematocele, varicocele and possible torsion. In 6 children the lesion s were more extensive than expected with deep perineal and/or inguinal involvement, including 2 who also had pelvic and retroperitoneal exte nsion, Incomplete excision led to recurrence in 4 patients. Conclusion s: Scrotal cystic lymphangioma presents as an unusual cystic scrotal m ass, Although misdiagnosis has been common, awareness of the character istic features of this lesion should lead to the correct preoperative diagnosis. When lymphangioma is suspected, imaging of the adjacent ing uinal, perineal and pelvic regions should be pc-formed. Complete excis ion is mandatory to prevent recurrence.