Title : Papillary cyst adenoma of epididymis presenting with recurrent hydrocele: A case report
Abstract:
Introduction: Papillary cystadenoma is a rare, benign paratesticular neoplasm that frequently mimics simple hydroceles, often leading to diagnostic delay and suboptimal surgical intervention.
Case Presentation: A 65-year-old hypertensive male presented with progressive right scrotal swelling three months post-bilateral hydrocele sac eversion. Ultrasonography revealed 26 ml of fluid and 6-mm scrotal wall thickening. Then excision of sac performed which also failed to improve his symptoms, in turn rapid scrotal enlargement was developed. Emergency exploration and right high inguinal orchidectomy were performed; histopathology confirmed papillary cystadenoma. The patient recovered uneventfully and drain was removed on postoperative day seven.
Discussion: Refractory hydroceles with marked wall thickening signal proliferative lesions rather than simple fluid dynamics. Early inguinal exploration in such cases can help rule out occult malignancies, while systemic evaluation for occult Von Hippel-Lindau disease remains equally important.
Conclusion: Papillary cystadenoma represents a rare diagnosis in scrotal surgery that is commonly missed. High inguinal orchidectomy provides definitive histopathologic diagnosis and curative therapy for recurrent presentations.
Keywords: Adenoma; Epididymis; Hydrocele; Papillary; Recurrence; Testis
