Tubercular Epididymo-orchitis Mimicking a Testicular tumor: Unusual Presentation of the Rare disease

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Tubercular Epididymo-orchitis Mimicking a Testicular tumor: Unusual Presentation of the Rare disease

Author Affiliations

¹ Pathology department, J.N. Medical College (JNMC), Aligarh Muslim University (AMU), Aligarh, UP, INDIA

Int. Res. J. Medical Sci., Volume 2, Issue (7), Pages 17-20, July,28 (2014)

Abstract

Isolated tubercular epididymitis or epididymo-orchitis is rare and may mimic a testicular tumor, posing a diagnostic and therapeutic challenge. A 56-yr-old male presented with a right-sided mass in scrotum from past 6 months, which was clinically and radiologically diagnosed as a testicular tumor. Right-sided orchidectomy was then done. However, the histopathological findings of the testicular mass revealed features consistent with tubercular epididymo-orchitis. Acid-fast bacilli staining of the histological sections also demonstrated the tubercle bacilli, confirmatory of diagnosis of tubercular epididymo-orchitis. This case emphasizes that tubercular epididymo-orchitis must be considered in the differential diagnosis of scrotal swelling in countries where prevalence of tuberculosis is high. A definite diagnosis is important to prevent unnecessary orchiectomy and subsequent effect on fertility.

References

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Wise G.J. and Shteynshlyuger A., An update on lower urinary tract tuberculosis, Curr Urol Rep, 9(4), 305–313, (2008)
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Fanning A., Tuberculosis: Extra pulmonary disease, CMAJ., 160, 1697-1603 (1990)
Miu W.C., Chung H.M., Tsai Y.C. and Luo F.J., Isolated tuberculous epididymitis masquerading as a scrotal tumour, J Microbiol Immunol Infect., 41(6), 528-530 (2008)
Cek M., Lenk S., Naber K.G., Bishop M.C., Johansen T.E., Botto H., Grabe M., Lobel B., Redorta J.P. and Tenke P., EAU guidelines for the management of genitou-rinary tuberculosis, Eur Urol., 48(3), 353–362 (2005)
Sah S.P., Bhadani P.P., Regmi R., Tiwari A. and Raj G.A., Fine needle aspiration cytology of tubercular epididymitis and epididymo-orchitis, Acta Cytol., 50(3), 243-249 (2006)

[ref1] Kapoor R., Ansari M.S., Mandhani A. and Gulia A., Clinical presentation and diagnostic approach in cases of genitourinary tuberculosis, Indian J Urol., 24(3), 401–405, (2008)

[ref2] Wise G.J. and Shteynshlyuger A., An update on lower urinary tract tuberculosis, Curr Urol Rep, 9(4), 305–313, (2008)

[ref3] Hopewell P.C., A clinical view of tuberculosis, Radiol Clin North Am, 33(4), 641–653 (1995)

[ref4] Shenoy V.P., Viswanath S., D’Souza A., Bairy I. and Thomas J., Isolated tuberculous epididym-oorchitis: an unusual presentation of tuberculosis, J Infect Dev Ctries., 6(1), 92–94 (2012)

[ref5] Chaurasia J.K., Garg C., Agarwal A. and Naim M., Tubercular thyroiditis with multinodular goitre with adenomatous hyperplasia: a rare coexistence. BMJ Case Rep, bcr-2013-200861 (2013)

[ref6] Marjorie P.G. and Holenarasipur R.V., Extrapulmonary tuberculosis: An overview, Am Fam Physician., 72(9), 1761–1768 (2005)

[ref7] Fanning A., Tuberculosis: Extra pulmonary disease, CMAJ., 160, 1697-1603 (1990)

[ref8] Miu W.C., Chung H.M., Tsai Y.C. and Luo F.J., Isolated tuberculous epididymitis masquerading as a scrotal tumour, J Microbiol Immunol Infect., 41(6), 528-530 (2008)

[ref9] Cek M., Lenk S., Naber K.G., Bishop M.C., Johansen T.E., Botto H., Grabe M., Lobel B., Redorta J.P. and Tenke P., EAU guidelines for the management of genitou-rinary tuberculosis, Eur Urol., 48(3), 353–362 (2005)

[ref10] Sah S.P., Bhadani P.P., Regmi R., Tiwari A. and Raj G.A., Fine needle aspiration cytology of tubercular epididymitis and epididymo-orchitis, Acta Cytol., 50(3), 243-249 (2006)