Case report of a giant primary scrotal lipoma: A rare entity mimicking irreducible inguinal hernia

Abstract

Primary scrotal lipomas of giant proportions are exceptionally rare and frequently present as an irreducible inguinoscrotal hernia leading to misdiagnosis. These lesions are often identified incidentally during surgical exploration, as in our case, posing a diagnostic dilemma. Diagnostic ambiguity associated with these swellings often results in inadequate preoperative evaluation, thereby presenting unforeseen challenges during surgery. Although scrotal exploration remains the definitive treatment, comprehensive preoperative assessment is crucial to avoid intraoperative surprises and to help the clinician provide better surgical planning and outcomes. Here, we report a case of a giant primary scrotal lipoma arising from the spermatic cord in a 47-year-old male, presenting as a painless, progressively enlarging, nontransilluminant scrotal swelling. The lesion was initially misdiagnosed as an irreducible inguinoscrotal hernia on ultrasound, highlighting the importance of adequate preoperative evaluation. In addition, we would like to emphasize the consideration of such a rare entity as the differential diagnosis of giant scrotal swellings.