WOFAPS 2025 8th World Congress of Pediatric Surgery

Metin Gündüz ¹, Fatma Betül Yiğit ¹, murat çelik ², Fatma Özcan Sıkı ¹, Mehmet Sarıkaya ¹, Tamer Sekmenli ¹, İlhan Çiftçi ¹

¹ Department of Pediatric Surgery, Selçuk University School of Medicine, Konya, Turkey
² Selcuk University Faculty of Medicine Department of Pathology

Introduction:
The concurrent occurrence of late-onset, testis-independent scrotal cystic lesions and germ cell aplasia after orchiopexy is an extremely rare condition.

Case Presentation:
A 15-year-old male patient had previously undergone surgery for bilateral undescended testes seven years earlier and for recurrent right undescended testis six years ago. In 2025, he developed a cystic lesion approximately 2 cm in diameter in the right scrotal region. The lesion was initially drained at an outside center but subsequently recurred. A 3×2×2 cm cyst was completely excised, and a testicular biopsy was performed. Histopathological examination revealed that the cystic structure was consistent with a hydrocele, while the biopsy from the testis demonstrated features consistent with germ cell aplasia (Sertoli cell-only syndrome).

Conclusion:
This case is notable for the coexistence of an isolated scrotal cyst and testicular germ cell aplasia in a patient with a history of bilateral and recurrent undescended testis surgery. It highlights the importance of long-term follow-up in patients with cryptorchidism and suggests that recurrent scrotal cystic lesions may be associated with underlying testicular dysgenesis.