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Huge multilocular spermatocele in a patient with left scrotal swelling


 Introduction: Most spermatoceles are asymptomatic, unilocular, and small in size. They are typically cystic dilatations of the tubules of the efferent ductus in the head of the epididymitis, and less commonly dilatations of the tubules of the rete testis or aberrant ductus. However, huge spermatoceles are rare and to cause discomfort and cosmetic problems.

 Case Report: We present a case of a 42-year-old male with huge multilocular spermatocele mimicking hydrocele, who suffered from left scrotal enlargement for several years. Scrotal ultrasonography and magnetic resonance imaging (MRI) showed multilocular cystic spaces at the head of the left testis. Surgical exploration was performed and the size of the removal specimen was approximately 8.5×6.5×6.0 cm. The aspirated fluid contained spermatozoa, and histopathological and immunohistochemical examinations of the specimen showed a multilocular spermatocele arising from the epididymitis. He has been followed up without any significant complaints and recurrence one year after the surgery.

 Conclusion: It is important to keep in mind for spermatocele when encounter giant cystic diseases with multilocular appearance adjacent to the testicle. In such cases surgical exploration can be recommended.
