A Rare Case of Testicular Tuberculosis Mimicking as Testicular Malignancy

Extrapulmonary tuberculosis (TB) represents 10%–15% of TB cases, with lymph nodes being the most frequent site in India. Genital TB is uncommon, and testicular TB is rarer, still accounting for only 3% of genital TB cases. Isolated testicular TB is extremely rare and often mimics other testicular co...

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Main Authors: S. Rishabh, K. Krishnamoorthy, T. Joseph Pratheeban, E. Mathan, O. M. Rahman Shahul Hameed
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Journal of Association of Pulmonologist of Tamil Nadu
Subjects:
Online Access:https://journals.lww.com/10.4103/japt.japt_19_24
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author S. Rishabh
K. Krishnamoorthy
T. Joseph Pratheeban
E. Mathan
O. M. Rahman Shahul Hameed
author_facet S. Rishabh
K. Krishnamoorthy
T. Joseph Pratheeban
E. Mathan
O. M. Rahman Shahul Hameed
author_sort S. Rishabh
collection DOAJ
description Extrapulmonary tuberculosis (TB) represents 10%–15% of TB cases, with lymph nodes being the most frequent site in India. Genital TB is uncommon, and testicular TB is rarer, still accounting for only 3% of genital TB cases. Isolated testicular TB is extremely rare and often mimics other testicular conditions, such as malignancy, complicating diagnosis. We present a case involving a 49-year-old male with diabetes and a history of smoking, who experienced bilateral scrotal swelling and pain over 3 months, accompanied by weight loss. He had no history of respiratory complaints, fever, TB, or significant medical history. Physical examination revealed bilateral scrotal swelling (3 cm × 3 cm) and multiple inguinal lymph nodes. Scrotal ultrasound demonstrated bilateral heterogeneously hypoechoic masses, while magnetic resonance imaging of the scrotum and testis identified solid cystic lesions with heterogeneous enhancement. Serum alpha-fetoprotein and lactate dehydrogenase levels were within normal limits. Fluorodeoxyglucose positron emission tomography–computed tomography revealed metabolically active lesions in both testes and several lymph nodes. Chest X-ray was normal. With a strong suspicion of malignancy, the patient underwent bilateral high inguinal orchiectomy. Histopathological analysis of the excised tissue showed dense epithelioid granulomas with caseous necrosis, indicative of TB. The patient was commenced on antitubercular therapy, with plans for continued monitoring. Although rare, isolated testicular TB should be included in the differential diagnosis of testicular masses. Prompt recognition and appropriate treatment are essential to prevent unnecessary surgical procedures and ensure optimal management.
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spelling doaj-art-ff40b37c8f8d46fda66640f9c2467ea42025-02-11T10:16:54ZengWolters Kluwer Medknow PublicationsJournal of Association of Pulmonologist of Tamil Nadu2772-63552772-63632025-01-0181343710.4103/japt.japt_19_24A Rare Case of Testicular Tuberculosis Mimicking as Testicular MalignancyS. RishabhK. KrishnamoorthyT. Joseph PratheebanE. MathanO. M. Rahman Shahul HameedExtrapulmonary tuberculosis (TB) represents 10%–15% of TB cases, with lymph nodes being the most frequent site in India. Genital TB is uncommon, and testicular TB is rarer, still accounting for only 3% of genital TB cases. Isolated testicular TB is extremely rare and often mimics other testicular conditions, such as malignancy, complicating diagnosis. We present a case involving a 49-year-old male with diabetes and a history of smoking, who experienced bilateral scrotal swelling and pain over 3 months, accompanied by weight loss. He had no history of respiratory complaints, fever, TB, or significant medical history. Physical examination revealed bilateral scrotal swelling (3 cm × 3 cm) and multiple inguinal lymph nodes. Scrotal ultrasound demonstrated bilateral heterogeneously hypoechoic masses, while magnetic resonance imaging of the scrotum and testis identified solid cystic lesions with heterogeneous enhancement. Serum alpha-fetoprotein and lactate dehydrogenase levels were within normal limits. Fluorodeoxyglucose positron emission tomography–computed tomography revealed metabolically active lesions in both testes and several lymph nodes. Chest X-ray was normal. With a strong suspicion of malignancy, the patient underwent bilateral high inguinal orchiectomy. Histopathological analysis of the excised tissue showed dense epithelioid granulomas with caseous necrosis, indicative of TB. The patient was commenced on antitubercular therapy, with plans for continued monitoring. Although rare, isolated testicular TB should be included in the differential diagnosis of testicular masses. Prompt recognition and appropriate treatment are essential to prevent unnecessary surgical procedures and ensure optimal management.https://journals.lww.com/10.4103/japt.japt_19_24antituberculous therapyhigh inguinal orchiectomytesticular tuberculosistesticular tumor
spellingShingle S. Rishabh
K. Krishnamoorthy
T. Joseph Pratheeban
E. Mathan
O. M. Rahman Shahul Hameed
A Rare Case of Testicular Tuberculosis Mimicking as Testicular Malignancy
Journal of Association of Pulmonologist of Tamil Nadu
antituberculous therapy
high inguinal orchiectomy
testicular tuberculosis
testicular tumor
title A Rare Case of Testicular Tuberculosis Mimicking as Testicular Malignancy
title_full A Rare Case of Testicular Tuberculosis Mimicking as Testicular Malignancy
title_fullStr A Rare Case of Testicular Tuberculosis Mimicking as Testicular Malignancy
title_full_unstemmed A Rare Case of Testicular Tuberculosis Mimicking as Testicular Malignancy
title_short A Rare Case of Testicular Tuberculosis Mimicking as Testicular Malignancy
title_sort rare case of testicular tuberculosis mimicking as testicular malignancy
topic antituberculous therapy
high inguinal orchiectomy
testicular tuberculosis
testicular tumor
url https://journals.lww.com/10.4103/japt.japt_19_24
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