There are many causes of inguinoscrotal swelling, but common causes include hydrocele, tumours, and infections. The presented case involves a 40-year-old male who presented with an inguinoscrotal mass on the right side that developed over the past year, accompanied by painful episodes. Physical examination revealed a 5×6 cm tense swelling with positive transillumination. Investigations showed a right-sided chronic hydrocele, funiculitis, varicocele, and epididymo-orchitis. Dissection for the hydrocele at the onset led to the identification of a right testicular mass, necessitating a high inguinal orchidectomy. Histopathological examination confirmed classic seminoma with capsular and lymphovascular invasion. This case highlights the diagnostic difficulty of inguinoscrotal swellings, particularly when hydrocele obscures an underlying tumour. The unexpected intraoperative findings underscore the importance of flexibility in surgical planning to address potential malignancy concerns. The report emphasizes the necessity of a proper histopathological assessment to determine the nature of the testicular mass for appropriate management in future cases.
Surapureddy et al. (Wed,) studied this question.