The typical patient with fat necrosis of the scrotum is a prepuberal heavy set male subject who has extratesticular scrotal masses, usually bilateral, with mild to moderate pain but no systemic complaints or symptoms related to voiding. The masses are firm, tender and do not transmit light. With a firm diagnosis expectant treatment will allow spontaneous resolution of the lesions. If doubt exists appropriate surgical intervention is advocated. Hypothermic injury, such as swimming in frigid water, is the most probable etiologic agent.
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