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

摘要

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.