Rare condition causes man’s testicles to swell to 7 pounds: case report

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A 43-year-old Panama man was the focus of a recent case report that detailed a rare condition that caused his testicles to swell to an enormous size.

The man, who was not identified in the report published in the medical journal Urology Case Reports, was brought to a local emergency room with a rapid heartbeat and fever, as well as swelling and drainage – described as “foul-smelling, purulent fluid” – coming from two open wounds on his scrotum.

The man had reportedly not been to a doctor in 30 years, meaning physicians treating him had little insight into his medical history.

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“Over the past three decades, his scrotal swelling had gradually worsened. He relied on a walker for ambulation and his mother attended to most of his daily needs,” the researchers wrote, noting that his genitals had swelled to roughly 7 pounds and were 11.8 x 9.6 x 5.1 inches.

The man's testicles weighed roughly 7 pounds swollen, doctors wrote. (Urology Case Reports)

The patient was then diagnosed with Fournier gangrene, what the National Organization for Rare Disorders describes as “an acute necrotic infection of the scrotum; penis; or perineum,” which is the area between the anus and the genitals.

“It is characterized by scrotum pain and redness with rapid progression to gangrene and sloughing of tissue. Fournier gangrene is usually secondary to perirectal or periurethral infections associated with local trauma, operative procedures, or urinary tract disease,” it adds.

The man had reportedly not seen a doctor in 30 years. (Urology Case Reports)

The condition most often affects men but has been reported in women and children in some cases. Urinary tract or bladder infections, hysterectomies and abscesses can sometimes lead to Fournier gangrene.

The man also suffered from grade 4 lymphedema on his right leg and groin — a category of swelling that’s most often associated with patients with elephantiasis, according to the report. A CT scan of the man’s abdomen and pelvis also revealed he was suffering from a massive hernia in his groin. He also had a large abscess and a swollen left kidney due to a buildup of urine. His flesh was also decaying.

The man's CT scan. (Urology Case Reports)

The patient required emergency surgery to remove the infected tissue on and near his scrotum. During the procedure, doctors were forced to perform a “dorsal slit” to his penis – meaning it was cut lengthwise – to insert a catheter.

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The man also underwent a scrotectomy, or a total or partial removal of the scrotum, they wrote, before a plastic surgery team at the hospital repaired the affected region.

Two days later, he was released to a rehab center.

At four weeks post-op, the man was “healing well with satisfactory cosmetic and functional outcomes,” doctors wrote in the report.