{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:07:37Z","timestamp":1788934057455,"version":"build-2803163510"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the clinical characteristics, risks of misdiagnosis, and diagnostic and management strategies for pediatric scrotal lymphatic malformation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on clinical data (demographics, symptoms, diagnostic work-up, and treatment) of 15 pediatric cases with scrotal lymphatic malformation treated at our institution between 2012 and 2025. Additionally, a targeted literature review of previously reported cases with diagnostic challenges was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All lesions showed a characteristic extratesticular distribution outside the tunica vaginalis. The overall accuracy rates of preoperative color Doppler ultrasound and clinical diagnosis were only 46.7% (7\/15) and 40.0% (6\/15), respectively. Furthermore, 26.7% (4\/15) of cases had an indeterminate preoperative diagnosis, and 33.3% (5\/15) were completely misdiagnosed. Surgical excision was performed in all patients, achieving complete resection in 10 cases and incomplete resection in 5 cases. Over a follow-up period ranging from 3 months to 6 years (mean, 22 months), 3 cases developed ipsilateral scrotal or inguinal recurrence, and 1 case presented with a gluteal lymphatic malformation one year postoperatively. A literature review identified an additional 12 reported cases with incorrect or indeterminate preoperative diagnoses. Indeterminate diagnosis was the largest category (41.7%), and among the definite misdiagnoses, hydrocele was the most common (25%), which closely mirrored the pattern observed in our series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pediatric scrotal lymphatic malformation is a rare entity that is highly prone to misdiagnosis and recurrence. Based on our 15-case series and reported cases, we propose a diagnostic and management algorithm integrating clinical evaluation, stepwise imaging, surgical excision, and selective sclerotherapy to improve diagnostic accuracy and optimize surgical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1898362","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:58:37Z","timestamp":1788933517000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric scrotal lymphatic malformation: a 15-case series and a proposed diagnostic and management algorithm"],"prefix":"10.3389","volume":"14","author":[{"given":"Lei","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Urology, Xi\u2019an Children\u2019s Hospital","place":["Xi\u2019an, 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