Acquired cryptorchidism: an unexpected consequence of inguinoscrotal lymphatic malformation treated with Eppikajutsuto

• Published in: BMJ case reports Vol. 14; no. 10; p. e243346
• Main Authors: Uebayashi, Elena Yukie, Ohno, Koichi, Iwade, Tamaki, Takada, Narito
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 04.10.2021; BMJ Publishing Group
• Subjects: Abdomen; Biomarkers; Case Report; Case reports; Cryptorchidism; Cysts; Intestinal obstruction; Laparoscopy; Neuroblastoma; Pain; Pediatrics; Sclerotherapy; Testes; Ultrasonic imaging; United States > US; Japan
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2021-243346

Lymphatic malformation (LM) that causes inguinoscrotal swelling is extremely rare. Surgery, sclerotherapy and pharmacotherapy have been reported as possible treatment options for LM. Recently, Eppikajutsuto (TJ-28), a traditional Japanese herbal medicine has emerged as therapeutic option for LM. We report the case of a 2-year-old boy who presented with a left inguinoscrotal swelling, which was diagnosed as retroperitoneal LM extending into the left scrotum. The surgical approach was less favourable, given the risk of damaging the testicular vasculature or the spermatic cord. Therefore, the patient received medical treatment with TJ-28. As a result, a volume reduction of 83% was obtained, as well as the unexpected consequence of the left testicle retracting into the inguinal area. Laparoscopic exploration was performed and a small bulge on the internal inguinal ring was detected. The patient’s acquired cryptorchidism was subsequently treated by orchidopexy.