Retroperitoneal lymphatic malformation causing scrotal swelling– a useful diagnostic work-up with two-phase MRI to differentiate from scrotal lymphatic malformation or abdomino-scrotal hydrocele

Ichijo, Chizue; Takami, Shohei; Suzuki, Kan; Fujishiro, Jun; Watanabe, Miho

doi:https://doi.org/10.1016/j.epsc.2020.101701

Retroperitoneal lymphatic malformation causing scrotal swelling– a useful diagnostic work-up with two-phase MRI to differentiate from scrotal lymphatic malformation or abdomino-scrotal hydrocele

Ichijo, Chizue; Takami, Shohei; Suzuki, Kan et al.

Journal of Pediatric Surgery Case Reports, 2021, 64, 101701

Number of Access:522（2025-08-15 01:09 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/78335

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Title	Retroperitoneal lymphatic malformation causing scrotal swelling– a useful diagnostic work-up with two-phase MRI to differentiate from scrotal lymphatic malformation or abdomino-scrotal hydrocele
Creator	CreatorName Ichijo, Chizue
	CreatorName Takami, Shohei
	NRID 1000080598508 1000080598508 CreatorName Suzuki, Kan
	NRID 1000060528438 1000060528438 CreatorName Fujishiro, Jun
	NRID 1000040791728 1000040791728 researchmap permalink miho miho Scopus Author ID 56282966800 56282966800 ORCID 0000-0001-6691-0611 0000-0001-6691-0611 CreatorName Watanabe, Miho
Subject	Laparoscopy
	MRI
	Retroperitoneal lymphatic malformation
Description	Chizue Ichijo, Shohei Takami, Kan Suzuki, Jun Fujishiro, Miho Watanabe, Retroperitoneal lymphatic malformation causing scrotal swelling– a useful diagnostic work-up with two-phase MRI to differentiate from scrotal lymphatic malformation or abdomino-scrotal hydrocele, Journal of Pediatric Surgery Case Reports, Volume 64, 2021, 101701, ISSN 2213-5766, https://doi.org/10.1016/j.epsc.2020.101701.
Abstract	Background: Lymphatic malformation (LM) is an abnormal collection of lymphatic fluid within cysts or channels. LM can occur in any part of the body, but LM leading to scrotal swelling is very rare, and this unusual location often leads to diagnostic errors because the most common cause of a scrotal cystic lesion is a hydrocele. In the case presented here, a previously healthy 3-year-old boy recently developed a left scrotal swelling clinically mimicking a communicating hydrocele. However, a diagnostic laparoscopy showed a cystic lesion at the left internal inguinal ring with a closed internal inguinal ring, which is not an expected finding of communicating hydrocele. Differential diagnoses at surgery were scrotal LM, retroperitoneal LM, or abdomino-scrotal hydrocele (ASH). Two phase MRI performed both at the time of scrotal swelling and scrotal non-swelling showed a retroperitoneal LM bulging into the scrotum via the inguinal canal. Therefore, the retroperitoneal LM was completely resected using the inguinal approach. Conclusion: LM causing scrotal cystic lesion is rare, and it requires a high index of suspicion to make the correct diagnosis. Laparoscopy was needed to rule out the communicating hydrocele, and two-phase MRI was very useful to differentiate retroperitoneal LM causing scrotal swelling from scrotal LM or ASH. Both examinations helped with diagnosis and treatment planning.
Publisher	Elsevier Inc.
Source Title	Journal of Pediatric Surgery Case Reports
Volume (Issue)	64
Page	101701
Date of Issued	2021-01
Language	English
Handle URL	https://hdl.handle.net/11094/78335
eISSN	22135766
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1016/j.epsc.2020.101701
Access Rights	open access
CopyRight	© 2020 The Authors. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Journal of Pediatric Surgery Case Reports. 2021, 64, p. 101701
DC.title	Retroperitoneal lymphatic malformation causing scrotal swelling– a useful diagnostic work-up with two-phase MRI to differentiate from scrotal lymphatic malformation or abdomino-scrotal hydrocele
DC.creator	Ichijo, Chizue
	Takami, Shohei
	Suzuki, Kan
	Fujishiro, Jun
	Watanabe, Miho
DC.publisher	Elsevier Inc.
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2021-01
DC.identifier	https://doi.org/10.1016/j.epsc.2020.101701
DC.subject	Laparoscopy
	MRI
	Retroperitoneal lymphatic malformation
DC.description	Chizue Ichijo, Shohei Takami, Kan Suzuki, Jun Fujishiro, Miho Watanabe, Retroperitoneal lymphatic malformation causing scrotal swelling– a useful diagnostic work-up with two-phase MRI to differentiate from scrotal lymphatic malformation or abdomino-scrotal hydrocele, Journal of Pediatric Surgery Case Reports, Volume 64, 2021, 101701, ISSN 2213-5766, https://doi.org/10.1016/j.epsc.2020.101701.
DCTERMS.abstract	Background: Lymphatic malformation (LM) is an abnormal collection of lymphatic fluid within cysts or channels. LM can occur in any part of the body, but LM leading to scrotal swelling is very rare, and this unusual location often leads to diagnostic errors because the most common cause of a scrotal cystic lesion is a hydrocele. In the case presented here, a previously healthy 3-year-old boy recently developed a left scrotal swelling clinically mimicking a communicating hydrocele. However, a diagnostic laparoscopy showed a cystic lesion at the left internal inguinal ring with a closed internal inguinal ring, which is not an expected finding of communicating hydrocele. Differential diagnoses at surgery were scrotal LM, retroperitoneal LM, or abdomino-scrotal hydrocele (ASH). Two phase MRI performed both at the time of scrotal swelling and scrotal non-swelling showed a retroperitoneal LM bulging into the scrotum via the inguinal canal. Therefore, the retroperitoneal LM was completely resected using the inguinal approach. Conclusion: LM causing scrotal cystic lesion is rare, and it requires a high index of suspicion to make the correct diagnosis. Laparoscopy was needed to rule out the communicating hydrocele, and two-phase MRI was very useful to differentiate retroperitoneal LM causing scrotal swelling from scrotal LM or ASH. Both examinations helped with diagnosis and treatment planning.
DC.rights	© 2020 The Authors. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
DC.format	78335
citation_title	Retroperitoneal lymphatic malformation causing scrotal swelling– a useful diagnostic work-up with two-phase MRI to differentiate from scrotal lymphatic malformation or abdomino-scrotal hydrocele
citation_author	Ichijo, Chizue
	Takami, Shohei
	Suzuki, Kan
	Fujishiro, Jun
	Watanabe, Miho
citation_publisher	Elsevier Inc.
citation_language	English
citation_date	2021-01
citation_journal_title	Journal of Pediatric Surgery Case Reports
citation_volume	64
citation_firstpage	101701
citation_doi	https://doi.org/10.1016/j.epsc.2020.101701
citation_public_url	https://hdl.handle.net/11094/78335

Retroperitoneal lymphatic malformation causing scrotal swelling– a useful diagnostic work-up with two-phase MRI to differentiate from scrotal lymphatic malformation or abdomino-scrotal hydrocele

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