Lymphoscintigraphic appearance of scrotal lymphatic reflux in a patient with idiopathic genital lymphedema

A 25-year-old, single man presented with penile and scrotal swelling and leakage of fluid from his scrotal skin for the last 12 years. On physical examination, the penile and scrotal skin was diffusely thickened as a result of lymphedema. There were multiple lymphangiomas, which caused eruptions and erythema on the scrotum, and the scrotal skin was wet with leaking lymph fluid. He had no history of surgery, radiation therapy, malignancy, or sexually transmitted disease. Lymphoscintigraphy showed abnormal reflux to the scrotum from the inguinal lymphatics. The patient was diagnosed with idiopathic genital lymphedema and treated with excision of the involved tissue followed by skin graft reconstruction.