XANTHOGRANULOMATOUS EPIDID YMITIS A Case Report

Abstract

A 45-year-old man with spinal injury and diabetes mellitus who complained high fever and progressive enlargement of left intrascrotal mass visited to our hospital. Preoperative ultrasonography demonstrated epididymitis and abscess formation. Left high orchiectomy was performed because testicular tumor could not be denied. Epididymis was replaces by bright yellow mass associated with abscess and adhered to testis strongly. Histopathologically, the mass diagnosed xanthogranulomatous epididymitis consisted of foamy macrophages and chronic inflammatory cells. This is the first case in Japanese medical literature.

Three cases of xanthogranulomatous epididymitis caused by E. coli

“…Of 19 xanthogranulomatous funiculitis and orchitisepididymitis cases, including ours, seven cases were associated with diabetes, 1,7,10,11 three cases with spinal injury or neuropathic bladder, 7,8,10 and four cases with benign prostatic hyperplasia and/or surgical intervention. 9,10 More than two-thirds of the cases were related to mechanical or functional obstruction in the spermatic tract, and/or to stasis of possibly infectious agents.…”

Xanthogranulomatous epididymitis

“…Xanthogranulomatous epididymitis is extremely rare. The present is only the third case reported in the English and Japanese literature [2,3]. The first case of xanthogranulomatous epididymitis was reported by Wiener et al [2]; who reported suppurative tissue changes arising from the epididymis that progressed into further xanthogranulomatous involvement.…”

Xanthogranulomatöse Epididymitis

“…Solitary XE has been described in only a few cases and this is the first case reported in south-eastern Europe [1][2][3][4][5]. To our knowledge, only 19 cases in the male genital system, involving the testis, epididymis and spermatic cord tissue, have been reported in the English literature [1][2][3][4][5][6][7][8].…”

“…To our knowledge, only 19 cases in the male genital system, involving the testis, epididymis and spermatic cord tissue, have been reported in the English literature [1][2][3][4][5][6][7][8]. In the genitourinary system, this process is more frequently seen in the kidney and bladder, and very rarely in the prostatic gland [10,11].…”

“…Xanthogranulomatous epididymis (XE) is extremely rare and has been described in only a few cases [1][2][3][4][5]. Possible predisposition factors include obstruction of the epididymis with sperm extravazation causing an autoimmune reaction, an ischemic process of the testis and genital tract associated with chronic infectious inflammation (Escherichia (E.) coli, Proteus mirabilis), or testicular ischemia secondary to arteriosclerosis, which may be present in older patients with a xanthogranulomatous process [11,14,15].…”