Surgical treatment of a huge scrotal elephantiasis

DOI: 10.22591/magyurol.2018.1.magyara.17

Authors:
Magyar András dr., Póth Sándor dr., Köves Béla dr., Tenke Péter dr.
Jahn Ferenc Dél-pesti Kórház és Rendelőintézet, Urológiai Osztály, Budapest (osztályvezető: Tenke Péter dr.)

Summary

Objective: While in subtropical areas elephantiasis of the scrotum, or scrotal lymphedema is a common disease, caused by endemic filariasis, in Hungary, this condition is rarely seen. In Europe the most common cause of scrotal elephantiasis is the occlusion of lymphatic vessels secondary to other medical disorders. We wish to demonstrate the proper diagnostic workup and the surgical management of a giant scrotal lymphedema.
Case report: Our patient is 66 years old, has not been abroad recently and has already undergone an abdominal reconstruction due to lymphedema before. Following laboratory testing and ultrasound examination, a biopsy of the scrotum was performed, which did not prove the presence of any malignancy or inflammation. After counselling with a plastic surgeon, the enormous scrotal mass was surgically removed, followed by plastic reconstructive surgery of the scrotum. The wound healed without any complication and the patient has reported a significant improvement in his quality of life.
Conclusion: The physician should find out if the patient has travelled to an area where filariasis is endemic. To exclude malignancy, biopsy of the scrotum might be necessary. The reconstruction of the scrotum requires plastic surgical expertise.

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