Extra Scrotal Spermatocele – A Unique Case Presentation & Brief Review of literature

Abstract

Background: Spermatoceles are extra testicular lesions caused by cystic dilation of the efferent ductules filled with clear/milky fluid containing spermatozoa usually diagnosed incidentally either as a scrotal swelling or by ultrasonography. Suspecting and diagnosing spermatoceles presenting at extra scrotal positions is extremely rare and very few cases have been described in literature thus far. This article attempts to depict a patient presenting with one such spermatocele at an unusual location which adds to the scarce literature on the subject. Case Presentation: A 60-year-old male presented with complaints of a gradually progressing left inguinal swelling for past 3 months with prior trivial scrotal trauma. Clinical evaluation and investigations revealed a 5 × 3 cm inguinal swelling extending up to the superior aspect of the left hemiscrotum that was confirmed as a spermatocele on pathological analysis at an unusual extra scrotal location. Conclusion: Spermatoceles presenting at extra scrotal locations are extremely rare occurrences as is evident by the scant available published literature. This report adds to the scarce literature and also alerts the practicing urologist/surgeon towards insisting on a complete physical examination including simple but effective examination techniques like the transillumination technique as an aid to diagnosis of spermatoceles that may present uniquely at uncommon (extrascrotal) locations as in the present case.