Torsion of Spermatic Cord Cyst; a Case Report

 In general surgery, the acute scrotum is equivalent to the acute abdomen, and any delay in treatment may be risky for testis functions, especially in children. Among acute scrotal etiologies, spermatic cord cyst or hydrocele could be misleading. Spermatic cord cysts can evoke long-term scrotal pain with acute exacerbation.

 Here we report a boy aged 14 years old referring to the emergency clinic with the complaint of high riding testis, acute scrotal pain, and decreased testicular perfusion in Doppler ultrasound, which all warranted immediate scrotal exploration. According to exploration, a cyst was found twisting around the testis, lacking any sign of ischemia. The cyst was marsupialized, and the contained serum liquid was drained.

 Management of torsion of the spermatic cord cyst can be conservative if it is confirmed with absolute certainty. Hence, spermatic cord cyst torsion possibly is a source of confusion requiring further research to improve the precision of diagnoses. A spermatic cord cyst or hydrocele torsion is a rare cause of acute scrotum with a good prognosis. However, every suspicion must be confirmed by scrotal exploration.