Testicular schistosomiasis as differential diagnosis for testicular nodules: a case report

Abstract

Despite its infrequent occurrence, testicular schistosomiasis forming pseudo-tumors can be considered in the differential diagnosis of testicular tumors, especially in areas where the parasitic disease is endemic. In this report, we present a case of testicular schistosomiasis caused by Schistosoma mansoni and mimicking a testicular neoplasm. We describe the patterns of a testicular nodule on ultrasonography and magnetic resonance images in a 46-year-old man. The nodule was removed after a pre-operative diagnosis of a non-malignant lesion. Histology demonstrated granulomas with epithelioid macrophages and eosinophils around S. mansoni eggs within a fi brous tissue that formed a nodular structure.

Ectopic forms of schistosomiasis mansoni in the second macroregion of Alagoas: case series report and review of the literature

“…Although schistosomiasis is endemic in many countries, S. mansoni infection with testicular involvement is extremely rare 20 . Its occurrence is attributed to the migration of eggs through the venous channels between the mesenteric veins and the internal spermatic vein, inducing an immune response and formation of granulomas associated with fibrotic changes 20,21 .…”

“…Its occurrence is attributed to the migration of eggs through the venous channels between the mesenteric veins and the internal spermatic vein, inducing an immune response and formation of granulomas associated with fibrotic changes 20,21 .…”

“…However, in this location schistosomiasis may be clinically characterized by unilateral testicular edema, gonadal atrophy, libido alterations, erectile dysfunction, infertility, and testicular nodulations, mimicking a neoplastic lesion that may in certain circumstances lead to unnecessary orchidectomy 20,21,23,24 .…”

“…In endemic areas it is fundamental to maintain a high degree of suspicion of testicular schistosomiasis as a differential diagnosis of testicular tumors in boys or adult males with a testicular mass 20,25 . The indication of radical orchiectomy should be carefully reviewed to avoid unnecessary invasive surgeries, especially in patients of reproductive age.…”

“…The indication of radical orchiectomy should be carefully reviewed to avoid unnecessary invasive surgeries, especially in patients of reproductive age. In this context, partial orchiectomy with intraoperative frozen section examination may be a safe and effective approach for the diagnosis and treatment of these benign lesions 20 .…”