Staged rotation flap scrotoplasty and orchidopexy in a patient with inguinal ectopic scrotum

A case of dumbbell-shaped accessory scrotum with concomitant lipoma

BACKGROUND

Accessory scrotum is a congenital scrotal anomaly that is usually located anterior to the anus and frequently presents with a lipoma in a bead-like shape. Herein, we present an unusual case of an accessory scrotum with a lipoma connected by a narrow stalk and located posterior to the anus.

CASE PRESENTATION

A 1-month-old boy was referred to our hospital for a perineal mass present at birth. He was born at 37 weeks and 2 days, with a birth weight of 2962 g. No abnormalities occurred during the perinatal period, and the birth was uneventful. The mass had an unusual shape, comprising two masses connected by a narrow stalk. The base of the mass was posterior to the anus and was connected to the rectal mucosa. The proximal mass was elastic and soft without skinfolds, whereas the distal mass was elastic and soft with a scrotum-like skinfolds. Magnetic resonance imaging showed no spina bifida. High-intensity adipose tissues in both masses and low-intensity vessels or fibrous stroma in cord-like structures between the two masses were found on T2-weighted images. At 3 months of age, the patient underwent resection in the prone jackknife position. No tumorous lesions were connected to the mass on the rectal and coccyx sides, and the mass was completely removed, preserving the anal sphincter. Histologically, the distal mass had characteristics of a scrotum, whereas the proximal mass was exclusively a lipoma. The connecting stalk had normal skin structures and a blood vessel with parallel-running nerve bundles. The postoperative course was uneventful, and the patient was discharged on postoperative day 6.

CONCLUSIONS

This case of accessory scrotum was unusual in its location and the presence of a stalk connecting the accessory scrotum and lipoma. The mechanism underlying accessory scrotum development remains unclear, and our report may impact the discourse regarding the embryological development of the accessory scrotum.

Unilateral Suprainguinal Ectopic Scrotum: Case Report and Literature Review

Ectopic scrotum is an infrequent congenital scrotal anomaly. Different surgical methods of correcting ectopic scrotum have been used, but none have produced optimal cosmetic results for all types. We describe a case of left ectopic suprainguinal scrotum in a 14-month-old boy who had an undescended left testicle and a left-sided scrotal skin tag. Single-stage rotational flap scrotoplasty and unilateral orchiopexy were performed; however, we modified the surgical technique of scrotal rotation by excising the intervening longitudinal skin. Eight months after surgery, the repositioned scrotum had a better appearance, and the affected testicle was similar in size to the contralateral one. In comparison with other surgical methods, pedicle flap rotation of the ectopic scrotal skin with excision of the intervening longitudinal skin may produce a better cosmetic outcome.

Ectopic scrotum and penoscrotal transposition: Case report and literature review

Background

Ectopic scrotum (ES) is an extremely rare congenital scrotal malformation. Ectopic scrotum with VATER/VACTERL [vertebral defects (V), anal atresia or anorectal malformations (A), cardiac defects (C), tracheoesophageal fistula with or without esophageal atresia (TE), cardiac defects, renal malformations (R), and limb defects (L)] association is even rarer. There are no uniform guidelines for diagnosis and treatment.

Clinical case

We described a 2-year-5-month-old boy who has ectopic scrotum and penoscrotal transposition and reviewed relevant literature in this report. We performed laparoscopy exploration, rotation flap scrotoplasty, and orchiopexy and achieved a great result during the postoperative follow-up.

Conclusions

Combined with the previous literature, we made a summary to come up with a plan for the diagnosis and treatment of ectopic scrotum. Rotation flap scrotoplasty and orchiopexy are worthy of considering operative methods in treating ES. For penoscrotal transposition or VATER/VACTERL association, we can treat the diseases individually.

Synchronous Development of Hemiscrotal Tissue in the Orthotopic and Ectopic Locations in Association with other Urological Anomalies

Ectopic scrotum is a rare form of congenital scrotal anomaly that is rarely encountered in pediatric surgical practice. Herein, we report an infant with a unilateral ectopic suprainguinal scrotum associated with undescended testis and multicystic dysplastic kidney. The case is reported in view of rarity of this anomaly in the general pediatric population.

The Utility of Double Opposing Transposition Flaps in the Management of Inguinal Ectopic Scrotum: Surgical Experience and Literature Review

An ectopic scrotum (ES) represents a rare developmental anomaly of the male genitalia. The condition usually represents a part of a wide spectrum pathology associated with other anomalies. The different locations in which an ectopic scrotum is found include inguinal, suprainguinal, infrainguinal, and/or perineum. There are several surgical techniques described in the literature related to the management of ES, but none of them showed superior results. We present a rare case of ectopic hemiscrotum managed as part of a multidisciplinary team approach, showing the utility of double opposing transposition z-plasty flaps in managing such a case.

One stage rotation flap scrotoplasty and orchidopexy for the correction of ectopic scrotum: A case report

Ectopic scrotum (ES) is a particularly rare congenital malformation of the scrotum and commonly associated with other congenital malformations. A 2-year-old boy was presented with ectopic scrotum, low lesion imperforate anus, spina bifida and pubic diastasis since birth. There are various surgical methods available to be discussed in the management of ES. We performed correction of the ectopic scrotum and concomitant bilateral orchidopexy in one stage of surgery. This procedure is relatively simpler to perform and gives out favorable cosmetic result.