|Year : 2021 | Volume
| Issue : 1 | Page : 64-65
Ectopic scrotum with undescended testis
Dinesh Kumar Barolia, Aditya Pratap Singh, Sunil Kumar Mehra, Vinita Chaturvedi, Gurudatt Raipuria
Department of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India
|Date of Submission||23-Sep-2019|
|Date of Decision||18-Jan-2020|
|Date of Acceptance||11-Mar-2020|
|Date of Web Publication||22-Jan-2021|
Aditya Pratap Singh
Near the Mali Hostel, Main Bali Road, Falna, Pali - 306 116, Rajasthan
Source of Support: None, Conflict of Interest: None
Ectopic scrotum is defined as abnormal position rather than normal position of the scrotum. Congenital scrotal anomalies are penoscrotal transposition, bifid scrotum, accessory scrotum, and ectopic scrotum. Associated anomalies with ectopic scrotum are inguinal hernia, ectopic ureter, vesical exstrophy, renal dysplasia, and agenesis. Ectopic scrotum is a rare congenital anomaly. We report a case of ectopic scrotum with undescended testis.
Keywords: Ectopic scrotum, hemiscrotum, scrotum, testis, undescended testis
|How to cite this article:|
Barolia DK, Singh AP, Mehra SK, Chaturvedi V, Raipuria G. Ectopic scrotum with undescended testis. Med J DY Patil Vidyapeeth 2021;14:64-5
|How to cite this URL:|
Barolia DK, Singh AP, Mehra SK, Chaturvedi V, Raipuria G. Ectopic scrotum with undescended testis. Med J DY Patil Vidyapeeth [serial online] 2021 [cited 2021 Feb 27];14:64-5. Available from: https://www.mjdrdypv.org/text.asp?2021/14/1/64/307671
| Introduction|| |
Ectopic scrotum is a congenital anomaly, a scrotum at aberrant position. Congenital scrotal anomalies are penoscrotal transposition, bifid scrotum, accessory scrotum, and ectopic scrotum. The most common position of ectopic scrotum is the suprainguinal region. Other positions are infrainguinal and perineal regions. Etiology of ectopic scrotum is not yet clear, but aberrant development of gubernaculum is accused for ectopic scrotum. We present here a case of ectopic scrotum which was hypoplastic, associated with undescended testis.
| Case Report|| |
A 2½-year-old male child, weighing 14 kg, was brought by his parents with chief complaint of absent left testis. He was the first child with a history of full-term normal vaginal delivery. Antenatal period was uneventful. There was no history of congenital anomalies in family. On local examination, there was hemiscrotum of the right at normal position with normal size testis. Left hemiscrotum was absent. There was a skin tag of 1.5 cm × 1 cm size, at the left suprainguinal region appearing like scrotum due to skin rugosity [Figure 1]a.There was no palpable testis in the scrotum like swelling. A left testis was palpable in the left inguinal canal. The abdomen was soft and no palpable lump. Blood investigations were normal in limits. Ultrasonography (USG) of the abdomen showed normal kidney, ureter, bladder, and other solid and hollow viscera. USG showed that the left testis was present in the inguinal canal. After getting preanesthetic fitness, he was explored for orchidopexy. Gubernaculum of the left testis was attached with a skin tag [Figure 1]b. Left orchidopexy was done at subcutaneous plane beside the right hemiscrotum. Scrotoplasty was not done because the left scrotum was hypoplastic. Hypoplastic scrotum was excised and repaired. Histopathology of the excised tag showed skin epithelium with underlying adnexal glands and fibromuscular tissues. Interstitial collagenization was present. All these histopathological findings were suggestive of hypoplastic scrotum. Postoperative period and 6-month follow-up were [Figure 1]c uneventful [Figure 1]d.
|Figure 1: (a) Left ectopic scrotum at the suprainguinal region. Testis is visible in the ectopic scrotum, (b) retraction of ectopic scrotum after stretching of gubernaculums, (c) histopathology of excised ectopic scrotum showed the fibromuscular tissue with collagenization and adnexal glands (×40, H and E), (d) the orchidopexy site wound and excised ectopic scrotum wound in follow-up|
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| Discussion|| |
Ectopic scrotum is less frequent than bifid scrotum, accessory scrotum, and penoscrotal transposition. Scrotum develops from the labioscrotal folds which migrate to genital tubercle inferomedially. Bloom et al. postulated that aberration in development of gubernaculum may cause labioscrotal fold defect that leads to ectopic scrotum. Mechanical pressure over developing scrotum site during embryological development leads to ectopic scrotum. This theory was proposed by Stephens in 1988. Bawa et al. reported a case of ectopic scrotum associated with anorectal malformation and sacral agenesis supports the mechanical pressure hypothesis. In our case, there was no evidence of mechanical pressure over the scrotal site. However, undescended testes along with ectopic testis prove that the hypothesis of aberrant development (of gubernaculum) may lead ectopic scrotum.
Surgical treatment of ectopic scrotum is scrotal transposition and orchidopexy. Moorthy et al. reported a case of ectopic hemiscrotum containing testis. They did scrotal transposition and orchiopexy. However, in our case, the scrotum was hypoplastic. Scrotal transposition was not possible; in such condition, we did orchidopexy in subcutaneous plane and excision of hypoplastic ectopic scrotum. Postoperative recovery was very satisfactory and cosmetically acceptable.
| Conclusion|| |
Very few cases of ectopic scrotum were reported in the English literature till date. This is treated by scrotal transposition and orchidopexy, but when ectopic scrotum is hypoplastic, then treatment of option is subcutaneous orchidopexy at the anatomical position and excision of hypoplastic scrotum. This maintains the self-esteem and cosmetically acceptance.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal.The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
The authors would like to thank Dr. Neelam Dogra, MD Anaesthesia, Senior Professor, SMS Medical College, Jaipur, Rajasthan, India.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
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