Abstract
Accessory scrotum (AS) is an extremely rare congenital anomaly, defined as scrotal-like tissue outside a normal anatomical location, without associated testes. It is often associated with perineal lipomas and other anomalies. We report a newborn male with a scrotum-like perineal mass posterior to the original scrotum. Postnatal assessment revealed a perineal mass resembling an AS. Ultrasound and CT confirmed a fat-containing mass, ruling out teratoma. A cystoscopy confirmed urinary tract integrity, and complete surgical excision of AS was conducted successfully. Although benign, AS presents a diagnostic challenge and may mimic other perineal anomalies. Complete resection is curative.