Spermatic cord enlargement due to lymphangioma

Abstract

Enlargements of spermatic cord are rare, but have the potential to affect testes health and fertility. A 4 year old American Quarter Horse stallion presented for semen collection and freezing in January of 2014. Evaluation of sperm quality indicated that the stallion was a good candidate for semen cryopreservation. As part of the manual evaluation of the scrotum and contents, a mass was identified in spermatic cord, just dorsal to right testis. Ultrasonographic assessment revealed a fluid filled, multiloculated structure. In addition, a polycystic pattern characterized the cranial portion of parenchyma within right testis. Since this lesion was not impairing sperm quality at that time, client decided to take the stallion home to breed during the 2014 breeding season. Four months after discharge, the stallion was readmitted because of poor sperm quality, which was confirmed following 3 semen collections (total motility 48 - 57%; progressive motility 38 - 51%; normal morphology 28 - 40%). Ultrasonography revealed the polycystic structure had enlarged in both spermatic cords and testis parenchyma, causing compression of left testis. Right spermatic cord and testis were removed surgically and submitted for histopathologic evaluation. Lymphangioma of the spermatic cord was diagnosed, an epithelial growth characterized by rapidly dividing lymphatic vessels within the connective tissue.1 Following orchiectomy, the stallion recovered. Although inguinal and axillary regions have been cited as lymphangioma predilection sites in horses,2 no known report of localization within the spermatic cord has been identified.3 While benign, most lymphangiomas tend to be locally invasive and interfere with health of associated structures,2,4 such as occurred in this case. Due to its physiologic impact, spermatic cord lymphangioma should be considered when polycystic structures are identified in the region of the spermatic cord.