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Lymphangiomas are congenital malformations of the lymphatic system. These tumors usually occur in the neck and axilla, occasionally in the mediastinum, retro peritoneum, and thigh. The scrotum and perineum are the least frequent sites. Although, spermatic cord lymphangiomas are very rare, they have to be considered in the differential diagnosis of the atypical cystic scrotal swellings in order to avoid misdiagnosis, improper treatment and recurrence. We report a 3-year old boy with cystic lymphangioma of the spermatic cord extending from inguinal canal down to involve the tunica vaginalis but not the scrotal wall, it was discovered intraoperatively in inguinal exploration for incompletely reducible inguinal swelling which found to be inguinal hernia in associated with the cystic lymphangioma of the spermatic cord so Lt inguinal herniotomy and complete surgical excision of the lymphangioma of the spermatic cord including the tunica vaginalis were done. Post operative followup for 3 years clinically and ultrasonographically indicated no recurrence. With presenting this case, we will review the literature on this subject.

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IntroductionDistal hypospadias is a common anomaly. Different surgical techniques have evolved through the years to manage this anomaly. Several factors may affect the prognosis. One of them is glans size. We compared the hybrid Mathieu urethroplasty (HMU) and the tubularized incised plate urethroplasty (TIPU) for the management of distal hypospadias with a small glans.MethodsSixty-eight patients with distal hypospadias were included and categorized into two groups. Group A (n = 33) and group B (n = 35) patients were treated by HMU and TIPU, respectively. All patients had a small glans. In group A, the patients underwent Mathieu urethroplasty plus a deep incision of the urethral plate. In group B, the patients underwent TIPU. Urethral stents were used in all cases. Hypospadias objective score evaluation (HOSE) was used to assess the results.ResultsUrethrocutaneous fistulae developed in two cases in group A and six cases in group B. Meatal stenosis was significantly lower (one case in group A vs. eight cases in group B). Glanular dehiscence occurred in two cases in group A and five cases in group B. The small glans strongly correlated with the development of both urethrocutaneous fistulae and meatal stenosis where the odd ratios were 3.500 (1.383–7.879) and 9.481 (1.114–12.669), respectively.ConclusionBoth techniques showed efficacy during management of patients with a small glans. HMU had better outcomes, shorter duration of stent and lesser incidence of complications than TIPU. Small glans was significantly related to urethrocutaneous fistulae and meatal stenosis in group B.