Introduction:

The necessity for complex and multidisciplinary approach of “border” surgical pathology has unanimously been agreed upon for such a long period of time, its advantages becoming even more obvious in rare, particular cases.

Patients and methods:

We report the case of a 39 year-old man diagnosed with lymphangiomatosis back in his childhood. He is admitted with a giant pseudotumoral scrotal mass presenting an important scrotal enlargement (40/35 cm).

Physical examination, blood tests, ultrasound, IVP, abdominal and chest CT, psychiatric and plastic surgery evaluation established the diagnosis: peno-scrotal lymphedema with gigantic hydrocele and depressive disorder. Taking into account the important enlargement of the scrotum associated with the alteration of the local skin, we decided to form a mixed surgical team: urology – plastic and reconstructive surgery.

We performed bilateral surgical therapy of hydrocele with partial excision and eversion of sac edges, excision of peno-scrotal skin and subcutaneous tissue surplus. At the end we made a reconstruction by using a partial-thickness graft from the normal skin of the left thigh.

Results:

Spinal anaesthesia was sufficient in order to perform a qualitative complex surgery. Intra and postoperative course was uneventful with minimal blood loss.

Conclusion:

Rare cases like this one clearly reveal the advantages of a multidisciplinary surgical team by combining usual surgical procedures from different specialities that could lead to spectacular results.