For citation purposes: Papadopoulos A, Bartziokas K, Morphopoulos G, Anastasiadis A, Makris D. A rare case of isolated tuberculous epididymitis in a young man presenting with a swollen testicle. OA Case Reports 2013 Jan 31;2(1):3.

Case report

 
Pathology

A rare case of isolated tuberculous epididymitis in a young man presenting with a swollen testicle

A Papadopoulos, K Bartziokas, G Morphopoulos, A Anastasiadis, D Makris
 

Authors affiliations

1Department of Respiratory Medicine, Nicosia General Hospital, Nicosia, Cyprus

2Department of Respiratory Medicine, General Hospital ‘Amalia Fleming’, Athens, Greece

3Department of Histopathology and Cytology, General Hospital ‘Amalia Fleming’, Athens, Greece

4Department of Obstetrics and Gynaecology, General Hospital - Maternity “Helena Venizelou”, Athens, Greece

5Department of Respiratory Medicine, University of Thessaly Medical School, Larissa, Greece

* Corresponding author Email: alexis_med@yahoo.gr

Abstract

Introduction

Isolated tuberculous epididymitis usually presents with a clinical picture and radiographic illustrations similar to those of a scrotal neoplasm; therefore, diagnosis can be challenging for physicians. This paper reports a rare case of isolated tuberculous epididymitis in a young man with swollen testicles.

Case report

A 32-year-old man with unremarkable past medical history was hospitalized for a swollen right testicle accompanied by localised pain and fever. Scrotal ultrasound and CT displayed a 27-mm lesion of the right testicle with no renal parenchymal masses. The possibility of a malignant tumour in this case was thought to be significant, and therefore the patient underwent a right inguinal orchiectomy. Histopathological examination of the removed testis revealed caseating granulomatous inflammation and necrosis with Langhans giant cells, typical of tuberculous infection.

Conclusion

Although the possibility of a scrotal neoplasm in young men with swollen testicle is high, diagnostic work-up in these patients should be thorough to avoid unnecessary orchectomies. Clinicians should also be aware of the case of isolated tuberculous epididymitis, an entity that can be potentially cured by anti-TB medications if diagnosed in an incipient phase.

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