A case of xanthogranulomatous orchitis and its preoperative diagnostic challenges

Xanthogranulomatous epididymo-orchitis: A single-institutional case series and systematic review

“…XGEO is a rare disease process with a description of 38 cases reported in 29 articles in medical literature. [ 1 2 6 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 ] The details of demographics and clinical profile of the patients are summarized in Table 1 . Most of these cases have been reported from the Asian continent ( n = 18), followed by Europe ( n = 13), North America ( n = 3), Africa ( n = 2), and 1 case each from South America and Australia.…”

Xanthogranulomatous epididymo-orchitis: A case report with review of the literature

“…A review of published cases demonstrated a predilection for this condition in the third to seventh decades of life [9] . XGO is a rare non-neoplastic destructive inflammatory condition of the testis that can result in a tumefactive lesion, mimicking malignant processes [10] . Young and elderly individuals are both susceptible to XGO.…”

“…Preoperative diagnosis of XGO can be taxing due to the clinical and radiological overlap with testicular neoplasms. Both entities manifest with painless, tumefactive testicular enlargement and can generate the impression of a mass lesion on radiologic studies [10] . Imaging thus has negligible impact on the diagnosis of XGO [14] .…”

“…Preoperatively, elevated serum tumor biomarkers provide a clue to the diagnosis of testicular malignancy. However, serum tumor markers can be normal in some testicular neoplasms, making differentiation between the two disorders even more difficult and necessitating histopathologic examination of the resected tissue for definitive diagnosis [10] . The characteristic microscopic finding in XGO is the detection of aggregates of foamy histiocytes admixed with a heterogeneous inflammatory cell infiltrate, causing widespread destruction and effacement of the testicular parenchyma [10] .…”

“…However, serum tumor markers can be normal in some testicular neoplasms, making differentiation between the two disorders even more difficult and necessitating histopathologic examination of the resected tissue for definitive diagnosis [10] . The characteristic microscopic finding in XGO is the detection of aggregates of foamy histiocytes admixed with a heterogeneous inflammatory cell infiltrate, causing widespread destruction and effacement of the testicular parenchyma [10] . Histopathologic examination of the current case revealed extensive mixed inflammatory cell infiltration of the testicular parenchyma, rete testis, and epididymal tissue, as well as complete destruction of the seminiferous tubules, liquefactive necrosis, suppuration, extensive fibrosis, and accumulation of foamy histiocytes with multinucleated giant cells.…”