A hard nut to crack?

Chronic swelling had developed into a shell in his scrotum

Doctors in India soon discovered this elderly man’s case was a little tougher than they first thought.

CT scan

The 80-year-old presented to their urology department with haematuria and voiding lower urinary tract symptoms.

On physical examination, they noted a grossly enlarged right testis that felt “stony hard”.

But a contrast-enhanced CT cracked the diagnosis, revealing a hydrocele in the right scrotal sac that appeared to have developed a thick, eggshell-like calcification around its