A 56-year-old white man presented to the surgical outpatient clinic with swelling of the right scrotum, which started approximately 6 months prior. Swelling was intermittent and sore. The patient noted that tumefaction was more prominent in the morning on waking, and he denied any associated fever, weight loss, or other symptoms. The patient had no significant medical story. Physical examination showed a painless but tender right scrotal tumefaction in an apparently healthy obese man. No inguinal lymphadenopathy was observed. Swelling was not reducible, the right testicle was not palpable, and the transillumination test was nondiagnostic. Laboratory evaluation demonstrated a hemoglobin level of 13.5 g/dL (to convert to grams per liter, multiply by 10.0), leukocyte or white blood cell count of 11 350/μL (to convert to ×10⁹ per liter, multiply by 0.001), and lactate dehydrogenase level of 240 U/L (to convert to microkatal per liter, multiply by 0.0167). Unenhanced computed tomography of the abdomen and pelvis was performed (Figure 1).

一名56岁的白人因右阴囊肿胀而出现在外科门诊，大约在6个月前开始。肿胀是间歇性的和疼痛的。该患者指出，早晨起床时肿胀更为明显，他否认有任何相关的发烧，体重减轻或其他症状。病人没有明显的医学故事。体格检查显示，在一个貌似健康的肥胖男子中，阴囊右侧无痛但无痛。没有观察到腹股沟淋巴结肿大。肿胀不可减少，右睾丸不可触及，透射检查无法诊断。实验室评估显示血红蛋白水平为13.5 g / dL（换算为克/升，乘以10.0），白细胞或白细胞计数为11350 /μL（换算为×10 ^9）每升乘以0.001），乳酸脱氢酶水平为240 U / L（转换为每升微卡塔尔，乘以0.0167）。对腹部和骨盆进行未增强的计算机体层摄影（图1）。