Abstract
Massive scrotal elephantiasis is a rare disease that usually requires a surgical approach. Lymphedema of the genitalia can have a different presentation that requires different treatment. The present study describes the case of a 43-year-old Caucasian male patient by scrotal elephantiasis of unknown causes with a buried penis. A novel surgical technique was applied for the treatment of massive scrotal elephantiasis and the authors present this single-center experience. Magnetic resonance imaging revealed the integrity of the corpora cavernosa, the spermatic cords, as well as the testes. The patient underwent a scrotectomy using a 'hanger-shaped incision' followed by scrotal reconstruction to obtain an adequate cosmetic outcome. The surgical approach to this uncommon disease is referred to as a 'hanger-shaped incision'. As demonstrated herein, this novel technique permits the formation of a trapezoidal cavity that allows the reconstruction of a neo-scrotum, a neo-septum and partially restoring the natural appearance of the genitalia.