Bilateral testicular tuberculomas: a case detection

• Published in: Andrologia Vol. 41; no. 2; pp. 130 - 135
• Main Authors: Hassan, A., El‐Mogy, S., Zalata, K., Mostafa, T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2009; Wiley-Blackwell
• Subjects: Adult; Bacterial diseases; Biological and medical sciences; Gynecology. Andrology. Obstetrics; Human bacterial diseases; Humans; Infectious diseases; Magnetic Resonance Imaging; Male; Male genital diseases; Medical sciences; Mycobacterium; Swellings; Testicular Diseases - diagnostic imaging; Testicular Diseases - pathology; testis; Testis - diagnostic imaging; Testis - pathology; Tuberculoma - diagnostic imaging; Tuberculoma - pathology; tuberculosis; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Urogenital - diagnostic imaging; Tuberculosis, Urogenital - pathology; Ultrasonography; Infection; Pseudotumor; Reproduction; Tuberculosis; Bacteriosis; Tumor; Tuberculoma; Swellings-testis-tuberculosisultrasonography; Mycobacterial infection; Testicle; Male genital system
• ISSN: 0303-4569; 1439-0272
• DOI: 10.1111/j.1439-0272.2008.00903.x

Summary Genitourinary tuberculosis (TB) is the most frequent manifestation of extrapulmonary TB, where the epididymides, seminal vesicles and prostate are the commonly infected sites, followed by the testes. We report a 29‐year‐old man who presented with primary infertility since 2 years. He had a history of bilateral painful scrotal swelling with fever since 4 years, diagnosed as pyogenic scrotal abscess, which was managed by incision and drainage. At presentation, fever, weight loss and night sweats were absent. On examination, he had ovoid slightly tender, firm to hard irregular masses in the lower poles of both testes with no line of separation encroaching on both epididymes. Both testes were not felt distinctly and the overlying scrotal skin showed no signs of inflammation. Semen analysis revealed azoospermia. Scrotal colour coded duplex ultrasonography demonstrated moderately enlarged testes having well defined hypoechoic masses with foci of calcifications. Magnetic resonance imaging confirmed these findings. Biopsy and histopathology detected the presence of caseating granuloma and Ziehl–Neelsen staining of paraffin sections demonstrated acid‐fast bacilli. The patient was treated with combination therapy. Tracing of the condition is discussed.