Unilateral Epididymo-Orchitis Tuberculosis Mimicking Tumor of the Scrotal

Abstract

Introduction: Tuberculosis (TB) is a global disease that can lead to morbidity and mortality if not adequately treated. Globally in 2019, an estimated 10.0 million (range 8.9-11.0 million) people fell ill with TB, and 15% and 40% of them present with extrapulmonary TB (EPTB), of which a considerable proportion have urogenital TB (UGTB). We present a case of unilateral epididymo-orchitis tuberculosis mimicking malignant tumor of the scrotal.

Purpose: To increase awareness of diagnosing scrotal tuberculosis, since it is infrequent and has some symptoms similar to malignant scrotal tumor. It is also to suggest the treatment after diagnosing scrotal tuberculosis.

Case report: A 38-year-old male presented to the Surgical Clinic of Lewoleba Regional General Hospital with a painful swelling of the right testis 6 months before admission to the hospital. This enlargement was progressive, getting bigger over time. The palpation of the right testicle is hard, and immobile, with a well-defined margin. He complained of a recurrent fever for the 6 months of his illness. He experienced a dry cough for several months. He experienced a weight loss of 10 kg in 6 months of the illness. No history of TB before.

Discussion: UGTB is defined as the infection of the urinary tract or genitalia most commonly caused by Mycobacterium tuberculosis (MTB). One kind of  UGTB is at the scrotal area. After primary Mtb infection at any organ site, direct hematogenous or lymphatic spread from primary Mtb lesions leads to Mtb seeding into various parts of the urogenital tract.

Conclusion: The presentation of scrotal tuberculosis is often vague and a high degree of awareness is needed to make the diagnosis. Patients with scrotal tuberculosis must be well-diagnosed to treat it properly. The histopathological examination is very important to eliminate the differential diagnosis of scrotal tumors.