Abstract

Xantogranulomatous epididymo-orchitis is an extremely rare inflammatory disease of the testis. The process can not be distinguished clinically from a malignant testicular tumor except on histological examination. To our knowledge there are only 18 cases reported in english literature.

A 34-year-old man presented with a month history of right testicular pain and swelling. Physical examination revealed severe tenderness with enlargement of the right hemiscrotum. Direct plain films and urinalysis were normal. Ultrasound examination of the right testis revealed non-homogeneous areas with poorly defined limits and hypoechoic-calcifying areas within the right testis and epididymis. A right testicular cancer was suspected and the patient had right inguinal orchiectomy. Microscopic examination showed diffuse replacement of seminiferous tubules and interstisium by sheets of foamy histiocytes intermingled with neutrophils, lymphocytes and plasma cells. Histochemical stains for organisms didn’ t yield any fungi or mycobacteria. A diagnosis of xantogranulomatous epididymo-orchitis was made.

Key Words: Testis; Xantogranulomatous Inflammation; Differential Diagnosis.