[Giant Scrotal Elephantiasis as a Septic Focus in Generalized Lymphedema: Radical Resection Following Initial...

This case report describes a rare and clinically highly complex constellation of massive scrotal elephantiasis, generalized lymphedema, and septic deterioration, which initially raised the suspicion of a malignant soft tissue tumor. The report highlights the diagnostic pitfalls associated with extreme scrotal enlargement, the nuanced decision-making regarding timing and extent of surgical intervention in a persistent septic setting, and the urological, pathological, and reconstructive implications of radical resection under extraordinary anatomical conditions. Reports of scrotal elephantiasis presenting as a primary septic focus in non-endemic regions remain rare and are largely limited to isolated case descriptions. This case illustrates clinically relevant diagnostic and therapeutic decision-making in the management of this unusual constellation.