A clinical case of acute scrotal syndrome on the background of primary scrotal lipoma and literature review

Background: Primary scrotal lipomas are exceptionally uncommon entities within the scrotal sac frequently occur in younger males under 40. It usually painless and found incidentally during imaging. They are generally categorized based on their site of origin. Case presentation: A 36-year-old man pre...

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Main Authors: Lim, Raymond Zhun Ming, Soo, Tze Hui, Mohamad Sharin, Mohamad Fairuz, Ilias, Aizat Sabri
Format: Article
Language:English
Published: Springer Science and Business Media Deutschland GmbH 2025
Online Access:http://psasir.upm.edu.my/id/eprint/118372/
http://psasir.upm.edu.my/id/eprint/118372/1/118372.pdf
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author Lim, Raymond Zhun Ming
Soo, Tze Hui
Mohamad Sharin, Mohamad Fairuz
Ilias, Aizat Sabri
author_facet Lim, Raymond Zhun Ming
Soo, Tze Hui
Mohamad Sharin, Mohamad Fairuz
Ilias, Aizat Sabri
author_sort Lim, Raymond Zhun Ming
building UPM Institutional Repository
collection Online Access
description Background: Primary scrotal lipomas are exceptionally uncommon entities within the scrotal sac frequently occur in younger males under 40. It usually painless and found incidentally during imaging. They are generally categorized based on their site of origin. Case presentation: A 36-year-old man presented with an acute onset of severe left scrotal pain at midnight. Clinical examination revealed two scrotal masses in the left hemiscrotum associated with excruciating tenderness on palpation and loss of cremasteric reflex. Ultrasonography showed a well-defined, oval-shaped, isoechoic lesion underlying the median raphe of scrotum alongside bilateral normal testes. Given the intensity of unexplained pain despite high dose of analgesia, urgent scrotal exploration was done. Intra-operatively, a yellowish, firm mass was identified at the upper pole of the left main testis which was excised. Histopathological examination revealed a primary scrotal lipoma with no necrotic area seen. Conclusions: Ultrasound is typically the first-line imaging technique to exclude more sinister pathology. The atypical presentation of excruciating pain mimicking testicular torsion in our case complicates the diagnostic process. Scrotal lipoma can be and should be excised as the standard treatment albeit found incidentally.
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spelling upm-1183722025-07-08T08:27:36Z http://psasir.upm.edu.my/id/eprint/118372/ A clinical case of acute scrotal syndrome on the background of primary scrotal lipoma and literature review Lim, Raymond Zhun Ming Soo, Tze Hui Mohamad Sharin, Mohamad Fairuz Ilias, Aizat Sabri Background: Primary scrotal lipomas are exceptionally uncommon entities within the scrotal sac frequently occur in younger males under 40. It usually painless and found incidentally during imaging. They are generally categorized based on their site of origin. Case presentation: A 36-year-old man presented with an acute onset of severe left scrotal pain at midnight. Clinical examination revealed two scrotal masses in the left hemiscrotum associated with excruciating tenderness on palpation and loss of cremasteric reflex. Ultrasonography showed a well-defined, oval-shaped, isoechoic lesion underlying the median raphe of scrotum alongside bilateral normal testes. Given the intensity of unexplained pain despite high dose of analgesia, urgent scrotal exploration was done. Intra-operatively, a yellowish, firm mass was identified at the upper pole of the left main testis which was excised. Histopathological examination revealed a primary scrotal lipoma with no necrotic area seen. Conclusions: Ultrasound is typically the first-line imaging technique to exclude more sinister pathology. The atypical presentation of excruciating pain mimicking testicular torsion in our case complicates the diagnostic process. Scrotal lipoma can be and should be excised as the standard treatment albeit found incidentally. Springer Science and Business Media Deutschland GmbH 2025-02-17 Article PeerReviewed text en cc_by_4 http://psasir.upm.edu.my/id/eprint/118372/1/118372.pdf Lim, Raymond Zhun Ming and Soo, Tze Hui and Mohamad Sharin, Mohamad Fairuz and Ilias, Aizat Sabri (2025) A clinical case of acute scrotal syndrome on the background of primary scrotal lipoma and literature review. African Journal of Urology, 31 (1). art. no. 19. pp. 1-5. ISSN 1110-5704; eISSN: 1961-9987 https://afju.springeropen.com/articles/10.1186/s12301-025-00490-1 10.1186/s12301-025-00490-1
spellingShingle Lim, Raymond Zhun Ming
Soo, Tze Hui
Mohamad Sharin, Mohamad Fairuz
Ilias, Aizat Sabri
A clinical case of acute scrotal syndrome on the background of primary scrotal lipoma and literature review
title A clinical case of acute scrotal syndrome on the background of primary scrotal lipoma and literature review
title_full A clinical case of acute scrotal syndrome on the background of primary scrotal lipoma and literature review
title_fullStr A clinical case of acute scrotal syndrome on the background of primary scrotal lipoma and literature review
title_full_unstemmed A clinical case of acute scrotal syndrome on the background of primary scrotal lipoma and literature review
title_short A clinical case of acute scrotal syndrome on the background of primary scrotal lipoma and literature review
title_sort clinical case of acute scrotal syndrome on the background of primary scrotal lipoma and literature review
url http://psasir.upm.edu.my/id/eprint/118372/
http://psasir.upm.edu.my/id/eprint/118372/
http://psasir.upm.edu.my/id/eprint/118372/
http://psasir.upm.edu.my/id/eprint/118372/1/118372.pdf