Case presentation A 50-year-old man presented with a history of gradual enlargement of the scrotal sac over twelve years. The swelling was painless and itchy. He had no history of lower urinary tract symptoms, pelvic surgery, or venereal disease. Examination A physical exam revealed a huge scrotal sac extending down to the upper third of the legs. The scrotal skin showed many scratch marks and hypopigmented areas. The penile sharp was buried within the scrotal mass, which made it difficult to examine the penis.
Urine came out through a tunnel leading to the glans penis. Testicles could not be palpated due to the huge size of the scrotal mass. The rest of the physical exam was normal. What is the most likely diagnosis for this patient? (Answer is posted in the comment section below!) *This patient case is from the Editorial Team of Docplexus and is meant for educational purposes only.
