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Published on: March 31, 2023
[Syringocele in children: an unusual presentation as scrotal mass]
A Marte1, M Prezioso, M D Sabatino
1Chirurgia Pediatrica Seconda Università degli Studi di Napoli, Napoli, Italia. antonio.marte@unina2.it
Insights
This case report details a rare pediatric syringocele (cystic dilation of Cowper gland duct) initially misdiagnosed as hydrocele. Advanced imaging confirmed urethral communication, leading to successful surgical treatment.
Area of Science:
- Pediatric Urology
- Medical Imaging
- Surgical Pathology
Background:
- Syringocele, a rare cystic dilation of the bulbourethral Cowper gland duct, is uncommon in children.
- Often asymptomatic, syringocele can manifest with voiding dysfunction and urinary tract infections (UTIs).
Observation:
- A 2-year-old boy presented with hydrocele, initially treated with hydrocelectomy.
- Relapse of the scrotal mass prompted advanced imaging (ultrasound, VCG, CT, MRI).
Findings:
- Imaging revealed a communication between the urethra and the scrotal mass, characteristic of syringocele.
- Histology initially suggested an epidermoid cyst, but subsequent findings confirmed syringocele.
Implications:
- This case highlights an unusual presentation of pediatric syringocele mimicking hydrocele.
- It underscores the importance of advanced imaging in diagnosing rare urogenital anomalies in children.
Abstract:
Syringocele is a cystic dilation of the excretory bulbourethral Cowper gland duct, and is a rather uncommon finding in pediatric age. It is frequently asymptomatic but sometimes may cause voiding symptoms and urinary tract infection (UTI). This case report describes an unusual manifestation of syringocele presenting with hydrocele. The case concerns a 2-year-old boy who was referred to our Clinic with a diagnosis of hydrocele. The patient underwent hydrocelectomy through a bilateral inguinal incision, but no clear communication with the patent peritoneal vaginal ducts could be demonstrated. The histology evidenced an epidermoid cyst. One year later the scrotal mass relapsed. Sonography, voiding cistography (VCG), computed tomography (CT) scan and magnetic resonance imaging (MRI) were performed. VCG, CT scan and MRI demonstrated the communication between the urethra and the scrotal mass. A surgical excision of the syringocele with endoscopic resection of the collar were performed. Syringocele is a rare entity in pediatrics. To this authors' knowledge there are no reports in the literature describing cases presenting with scrotal mass.
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