Isolated tuberculous epididymitis presenting as a painless scrotal tumor

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• 作者：Victor Ka-Siong Kho ; Pei-Hui Chan ; ^{pfchan1952@yahoo.com.tw}
• 关键词：genitourinary tuberculosis ; isolated tuberculous epididymitis ; orchiectomy ; scrotal tumor ; scrotal ultrasound
• 刊名：Journal of the Chinese Medical Association
• 出版年：2012
• 期刊代码：210_17264901
• 类别：med
• 出版时间：June, 2012
• 卷：75
• 期：6
• 页码：292-295
• 文件大小：983 K

摘要

Genitourinary tuberculosis, the second most common extrapulmonary tuberculosis (TB), is very difficult to diagnose unless one maintains a high index of suspicion. Isolated tuberculous epididymitis (ITE), defined as tuberculous epididymitis without clinical evidence of either renal or prostate involvement, is a rare entity among genitourinary tuberculosis. When diagnosed correctly, ITE can be cured with anti-TB medications. However, patients with poor response to medical treatment may require surgery. Here, we report a 20-year-old man who presented with a slow-growing painless scrotal tumor for 2 months, with the initial workup suspicious for a right paratesticular tumor. Surgical resection of the tumor was therefore scheduled. However, severe pain and redness over the patient's right hemi-scrotum were noted on the day of surgery. A repeat scrotal ultrasound was performed that revealed findings suggesting a chronic inflammatory process rather than a malignancy. Frozen section of the lesion confirmed the ultrasonographic findings, and the pathology established the diagnosis of ITE. The patient remained on anti-TB therapy postoperatively for 6 months and had an excellent outcome.