CASE HISTORY

8 months before admission, the patient noticed a painless soft swelling above the testicle in the right groin. It appeared on standing and disappeared on lying down. 3 weeks before admission, he noticed a painless swollen right testicle. It had not fluctuated in size, neither had it been tender or painful. The skin over the testicle was normal. No disturbance of  micturition was present. On examination, the left inguinal region, spermatic cord, testicle and epididymis were normal. No disturbance of micturition was present. On examination, the left inguinal region, spermatic cord, testicle and epididymis were normal. On the right side, there was an inguinal hernia. The cord was thickened but the vas was of normal thickness. Epididymis and testicle could not be distinctly felt because of a hydrocele. The skin was intact. Per rectum, a small lump was felt on each side of the otherwise normal prostate. The lumps were attached to each upper lateral lobe and not to the rectal mucosa. On 6.9.49 a right orchidectomy was performed and repaired a right direct inguinal hernia. The patient made an uneventful recovery.

PATHOLOGY

The specimen consists of half the testis and epididymis with the beginning of the spermatic cord. The testis is normal. The epididymis is enlarged; the globus minor and body are occupied by dense fibrous scar tissue.