Massive Scrotal Lymphedema in an Adolescent with Intellectual Disability: A Rare Case of Infection-Related Scrotal Enlargement Requiring Subtotal Scrotectomy

An uncommon disorder marked by aberrant fluid accumulation brought on by lymphatic blockage, scrotal lymphedema presents major functional, cosmetic, and hygiene problems. It can be acquired or congenital; the most often occurring causes are infection, persistent inflammation, and filariasis. This case report describes a 17-year-old male patient with intellectual disability who had severe scrotal lymphedema that gradually developed over four years, causing problems with ambulation and hygienic care. Under a clinical examination, the scrotum (40 x 15 cm) was swollen and expanded, hiding the penis but having palpable testes. Ultrasound verified without testicular involvement scrotal wall thickening. After a subtotal scrotectomy preserves the testes, penis, and spermatic cord, scrotal reconstruction was done considering the functional limitation. Chronic inflammatory alterations without filarial organisms revealed by histopathology suggested an etiology connected to infections. The patient healed postoperatively with better mobility and hygienic standards. This example emphasizes the need for early identification and surgical intervention in controlling large scrotal lymphedema to maximize functional and cosmetic results.