Perineal lipoma on an accessory scrotum: A case report

Context: Accessory scrotum is a rare congenital malformation, often associated with other perineal anomalies, of which perineal lipoma is the most frequently described association. This unusual entity poses a diagnostic challenge, particularly in the differential diagnosis with other congenital perineal masses. Imaging plays an essential role in characterizing the nature of the lesion, defining its anatomical relationships, and guiding therapeutic management.

Case presentation: We report the case of a 1-year-old patient, born to non-consanguineous parents, with no medical or surgical history, who presented for management of a congenital subscrotal mass that had been progressively increasing in size. The patient initially underwent ultrasonography followed by cross-sectional imaging. The diagnosis of a perineal lipoma associated with an accessory scrotum was established, with specification of its relationships to the adjacent perineal and genital structures. No deep extension or communication with the pelvic organs was demonstrated.

Conclusion: Perineal lipoma on an accessory scrotum constitutes an exceptional association whose recognition relies largely on imaging. Imaging allows precise characterization of the lesion, comprehensive anatomical assessment, and optimal therapeutic guidance. Knowledge of this entity by the radiologist is essential in order to avoid diagnostic errors and to contribute effectively to multidisciplinary management.