Cystic hygroma of spermatic cord: the hidden mystery

Lymphangioma is a benign infiltrative malformation of lymphatic channels commonly occuring in neck, axilla, mediastinum and retroperitoneum. It is mostly congenital but may also occur secondary to trauma, infection, inflammation or degeneration. Cystic hygroma is a subtype of lymphangioma which exhibits large cystic (macro-cystic) spaces histologically. We report a rare case of a 17 year old boy who presentedwith a painless cystic inguino-scrotal swelling. After inguinal exploration, histopathological examination of excised cystic mass showed it to be a lymphatic malformation (cystic hygroma) of spermatic cord. Complete surgical excision of cystic hygroma with preservation of cord structures was performed. Any cystic inguinal swelling should alert the surgeon to consider the possibility of inguinal lymphatic malformation as a differential diagnosis. Complete surgical excision of lymphangioma is mandatory to prevent recurrence.