When a Hydrocele Is Not Just a Hydrocele: Case Report and Literature Review

Introduction: Paratesticular rhabdomyosarcoma (RMS) is a rare solid tumour in children, accounting for approximately 8.4% of all scrotal masses. Its clinical presentation is often nonspecific, making early diagnosis challenging.Methods: The study began with a comprehensive review of the patient's medical documentation. Subsequently, a literature search was performed using PubMed and Google Scholar, employing the keywords paratesticular, rhabdomyosarcoma, children, and testicular tumour to identify relevant studies.Case report: We present the case of an 18-month-old boy with a history of right-sided hydrocele, referred due to painless scrotal enlargement. Imaging revealed a solid mass closely associated with the testis. Tumour markers AFP and β-hCG were within normal range, with elevated LDH. Right orchiectomy was performed. Histopathological and genetic analysis confirmed embryonal RMS. The patient received oncological therapy and remains in good health at follow-up.Conclusion: Paratesticular RMS may mimic benign conditions such as hydrocele. It should be included in the differential diagnosis of persistent or recurrent scrotal enlargement in children.