A case of testicular tuberculosis mimicking malignancy in a healthy young man

Abraham, Sherly; Anariba, Dora Ernestina Izaguirre; Dua, Kirandeep; Mir, Mohammad Muzaffar; Ankireddypalli, Arvind

doi:10.1177/2049936116655261

Cited by 12 publications

(16 citation statements)

References 11 publications

(36 reference statements)

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“…However, it is worth noting that Bedi et al has successfully treated a 38-year-old patient with TBEO by standard anti-tuberculous medications [ 14 ]. Besides, Abraham et al also reported an Ecuadorian man with TBEO who was cured with 6 months of drug therapy and no surgery was required [ 21 ]. Therefore, for patients at early stages without server complications, standard anti-tuberculosis chemotherapy is still necessary to avoid surgical resection [ 15 , 16 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical management of tuberculous epididymo-orchitis: a retrospective study of 81 cases with long-term follow-up

et al. 2021

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Background Nowadays, most studies of tuberculous epididymo-orchitis (TBEO) are case reports or small sample cohort series. Our study is aimed to present the largest series of TBEO with our management experiences and long-term follow-up outcomes. Methods Patients diagnosed with TBEO after surgical procedures at Department of Urology, West China Hospital from 2008 to 2019 were included. All clinical features, auxiliary examination results, treatment and histopathological findings were extracted if available. Results Eighty-one patients (mean age 50.77 ± 16.1 years) were included. Scrotal swelling (N = 47, 58.0%) and pain (N = 29, 35.8%) were the most common presenting complaint. Pyuria and microscopic hematuria were observed in twenty-two (27.2%) and eight patients (9.9%), respectively. Urine acid fast bacilli cultures were available in 16 patients and all were negative. The mean duration between the onset of symptoms and the definite diagnosis was 6.42 ± 7.0 months. TBEO was considered in 30 (37.0%), tumors in 28 (34.6%) and nonspecific bacterial epididymo-orchitis in 23 (28.4%) patients. All patients received triple therapy of chemotherapy-surgery-pharmacotherapy and definite diagnosis was confirmed through histopathology of surgical specimens. Fifty-five patients were followed up regularly (mean follow-up 82.35 ± 36.6 months). One patient (1.2%) died from liver cirrhosis and no recurrence was observed. Postoperative complications included erectile dysfunction in 4 patients (4.9%), premature ejaculation in 5 patients (6.2%) and sterility in 7 patients (8.6%). Conclusions We recommend patients with advanced TBEO to receive triple therapy of chemotherapy-surgery-pharmacotherapy. Physicians should pay more attention to patients’ sexual function and fertility during follow up after treatment completed.

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Section: Discussionmentioning

confidence: 99%

Surgical management of tuberculous epididymo-orchitis: a retrospective study of 81 cases with long-term follow-up

et al. 2021

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“…Samples were smear-positive for AFB and subsequent culture confirmed a fully-sensitive M. tuberculosis . He was treated successfully with 6 months of drug therapy and no surgical intervention was required 1…”

Section: Discussionmentioning

confidence: 99%

“…Tuberculosis (TB) is well known to mimic other pathology, which can lead to delayed or missed diagnosis 1–5. TB remains a major global health problem.…”

Section: Introductionmentioning

confidence: 99%

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Atypical testicular pain

et al. 2019

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Testicular tuberculosis (TB) is rare, and, because of this, the lack of pathognomonic clinical features and its tendency to mimic other commoner conditions, the diagnosis is frequently delayed or may be missed. In this case, the initial clinical presentation was typical for bacterial epididymo-orchitis in a 38-year-old man. When the patient failed to improve with standard treatment including broadening of antibiotics, the diagnosis was re-considered because some unusual signs suggested testicular malignancy or lymphoma. Further, history-taking and subsequent cross-sectional imaging with CT/MRI identified co-existent pulmonary nodularity, thoracic and abdominal lymphadenopathy and bony changes that, together, raised the suspicion of TB. Mycobacterium tuberculosis was confirmed on DNA-based testing of the hydrocele fluid, although standard acid-fast bacilli culture was negative. This case prompted a review of the literature to explore the optimal steps in the investigation and diagnosis of this rare disease.

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“…The distribution of color blood flow signals was divided into levels 0-III, according to the Adler semiquantitative standard (13). Based on previous studies, the sonography of testicular and/or epididymal TB can be categorized into 4 types: type 1, diffusely enlarged heterogeneously or homogeneously lesion; type 2, nodular enlarged heterogeneously lesion; type 3, multiple small hypoechoic nodules (miliary type); type 4, space-occupying lesions (10,11,14,15).…”

Section: Data Acquisition and Analysis By Scrotum Ultrasonography Abdominal And Pelvic Ct/mrimentioning

confidence: 99%

A better understanding of testicular and/or epididymal tuberculosis based on clinical, ultrasonic, computed tomography, and magnetic resonance imaging features at a high-volume institute in the modern era

Li¹,

Chen²,

Fang³

et al. 2021

Quant Imaging Med Surg

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Background: There is a concerning underdiagnosis of testicular and/or epididymal tuberculosis (TB).A lack of clinician awareness has led to many patients undergoing unnecessary surgeries. The purpose of this series was to enhance understanding of testicular and/or epididymal TB based on clinical, ultrasonic, computed tomography (CT), and magnetic resonance imaging (MRI) features from the past decade.Methods: We retrospectively investigated the medical records of 69 patients diagnosed with testicular and/ or epididymal TB from 2008 to 2019. All participants were diagnosed by confirmation of Mycobacterium tuberculosis in the histopathology of resected samples. Baseline characteristics, ultrasonic, CT, and MRI features were collected for analysis.Results: A total of 69 patients with a median age of 43.5 years were included in the study. Testicularepididymis TB, epididymal TB, and testicular TB were confirmed in 31 (44.9%), 26 (37.7%), and 12 (17.4%) patients, respectively. In sonography, testicular TB and epididymal TB imaging features are significantly different (P<0.001). Diffusely enlarged lesion heterogeneously (33/58, 56.9%) is most common in the epididymis, and miliary type (18/39, 46.2%) is most common in the testis. On enhanced CT, annular or multilocular enhancement pattern (19/21, 90.5%) was the characteristic manifestation of our patients. Conclusions: Laboratory findings [especially T lymphocyte spot test for tuberculosis infection (T-SPOT.TB)], accompanied by scrotal sonography and enhanced CT examinations, can help distinguish testicular and/or epididymal TB from other etiologies.

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A case of testicular tuberculosis mimicking malignancy in a healthy young man

Cited by 12 publications

References 11 publications

Surgical management of tuberculous epididymo-orchitis: a retrospective study of 81 cases with long-term follow-up

Surgical management of tuberculous epididymo-orchitis: a retrospective study of 81 cases with long-term follow-up

Atypical testicular pain

A better understanding of testicular and/or epididymal tuberculosis based on clinical, ultrasonic, computed tomography, and magnetic resonance imaging features at a high-volume institute in the modern era

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