A Case of Testicular Granulomatous Inflammation Mistaken for Malignancy: Tuberculosis Identified Post Orchiectomy. (July 2020)

• Record Type: Journal Article
• Authors: Civelli, Valerie F.; Heidari, Arash; Valdez, Michael C.; Narang, Vishal K.; Johnson, Royce H.
• Is Part Of: Journal of investigative medicine high impact case reports. Volume 8(2020)
• Publication Date: 2020-07
• Subjects: orchiectomy -- testicular malignancy -- testicular granuloma -- testicular tuberculosis -- infectious granuloma -- granulomatous inflammation; Internal medicine -- Periodicals; Medical care -- Periodicals; 616.005
• DOI: 10.1177/2324709620938947
• Languages: English
• ISSNs: 2324-7096

Abstract

We describe the case of a 41-year-old Hispanic male, inconsistently adherent to visits and workup due to socioeconomic challenges, who presented with a right testicular mass. Because of the overriding concern that this was malignant, he underwent a right orchiectomy. Pathology revealed granulomatous disease with no evidence of malignancy. No specific diagnosis was made histologically or microbiologically on primary laboratory investigation. Six months later, he developed swelling of the left testicle and was subsequently seen in consultation at the Infectious Disease Clinic Kern Medical. An extensive evaluation for granulomatous inflammation was undertaken without a positive result. A clinical diagnosis of tuberculous epididymal orchitis was made and the patient was initiated on standard 4-drug antituberculous therapy. There was a gradual resolution of pain and swelling. After 6 months of therapy, there was no evidence of residual disease. The patient remains asymptomatic after 8 months of post-therapy follow-up.