Accessory scrotum with perineal lipoma diagnosed prenatally: case report and review of the literature

Abstract

We report a case of accessory scrotum (AS) in the perineal region with peduncular lipoma, diagnosed prenatally. A male fetus of 31 weeks' gestation was referred to our department with a perineal mass. Prenatal ultrasonography and magnetic resonance imaging showed a mass of 1.0 × 1.2 cm located posterior to the scrotum. No other abnormalities were noted during pregnancy. The patient was delivered vaginally at 38 weeks of gestation. On physical examination, a soft peduncular mass with a rugged and pigmented swelling was located between the normally developed scrotum and the anus. There were no specific symptoms or any other associated congenital anomalies. We completely excised the mass at one month of age. A histological examination revealed lipoma, with tissue suggestive of scrotum, so a definite diagnosis of AS was made. AS is a rare congenital anomaly of the scrotum. We review the literature.

Keywords: accessory scrotum; congenital scrotal anomaly; neonate; perineal lipoma; prenatal diagnosis.

Fig. 1

MRI at 31 weeks of gestation. Arrowheads indicate a 1.0 × 1.2 cm mass located posterior to the scrotum.

Fig. 2

a. A soft peduncular mass with a rugged and pigmented swelling is located posterior to the normally developed scrotum. b. Lateral view. c. The mass is attached at the midperineum with a skin tag.

Fig. 3

Histological examination. a. Macroscopic image b. The peduncular mass consists of mature adipose tissue. c. Smooth muscle fibers in the subcutaneous layer of the rugged swelling represent the tunica dartos.