Infect Chemother IC Infection & Chemotherapy 2093-2340 2092-6448 The Korean Society of Infectious Diseases and Korean Society for Chemotherapy 10.3947/ic.2011.43.1.68 Case Report Testicular Tuberculosis That Mimicked Testicular Cancer Kim Won Jin Shin Kyung Hwa Kim Mi Hyun Cho Woo Hyun Lee Kwangha Kim Ki Uk Jeon Doo Soo Park Hye-Kyung Kim Yun Seong Lee Min Ki Park Soon Kew Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. Correspondence to Ki Uk Kim, M.D. Department of Internal Medicine, Pusan National University Hospital, 1-10 Ami-dong, Seo-gu, Busan 602-739, Korea. Tel: +82.51-240-7804, Fax: +82.51-254-3127, uk303@hanmail.net 02 2011 28 02 2011 43 1 68 71 07 07 2010 22 07 2010 20 09 2010 Copyright © 2011 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Next to lymphatic involvement, genitourinary tuberculosis is considered the second most common manifestation of extrapulmonary tuberculosis worldwide. However, testicular and spermatic cord involvement is uncommon. We report here on a case of testicular and spermatic cord tuberculosis that masqueraded as testicular cancer. A 25-year-old man was admitted to our hospital with painless right scrotal swelling for past 2 months. The abdominal CT scan showed a heterogenous testicular mass that was suspicious for being malignancy. He underwent right radical orchiectomy; testicular and spermatic cord tuberculosis was revealed on histopathological examination. This case highlights the importance of taking a thoughtful diagnostic approach for testicular and spermatic cord tuberculosis, including fine needle aspiration before performing surgical exploration.

 Urogenital tuberculosis Urogenital cancer Testicular cancer Jacob JT Nguyen TM Ray SM Male genital tuberculosis Lancet Infect Dis 2008 8 335 342 Biswas M Rahi R Tiwary SK Khanna R Khanna AK Isolated tuberculosis of testis Kathmandu Univ Med J (KUMJ) 2006 4 98 99 Korea Center for Disease Control and Prevention, Korean Institute of Tuberculosis Annual report on the notified tuberculosis patients in Korea 2008 Seoul Korea Center for Disease Control and Prevention, Korean Institute of Tuberculosis Kulchavenya E Khomyakov V Male genital tuberculosis in Siberians World J Urol 2006 24 74 78 Gokce G Kilicarslan H Ayan S Tas F Akar R Kaya K Gultekin EY Genitourinary tuberculosis: a review of 174 cases Scand J Infect Dis 2002 34 338 340 Lee Y Huang W Huang J Wang J Yu C Jiaan B Huang J Efficacy of chemotherapy for prostatic tuberculosis-a clinical and histologic follow-up study Urology 2001 57 872 877 Moussa OM Eraky I El-Far MA Osman HG Ghoneim MA Rapid diagnosis of genitourinary tuberculosis by polymerase chain reaction and non-radioactive DNA hybridization J Urol 2000 164 584 588 Hemal AK Gupta NP Rajeev TP Kumar R Dar L Seth P Polymerase chain reaction in clinically suspected genitourinary tuberculosis: comparison with intravenous urography, bladder biopsy, and urine acid fast bacilli culture Urology 2000 56 570 574 Torrea G Van de Perre P Ouedraogo M Zougba A Sawadogo A Dingtoumda B Diallo B Defer MC Sombié I Zanetti S Sechi LA PCR-based detection of the Mycobacterium tuberculosis complex in urine of HIV-infected and uninfected pulmonary and extrapulmonary tuberculosis patients in Burkina Faso J Med Microbiol 2005 54 39 44 Wang LJ Wong YC Chen CJ Lim KE CT features of genitourinary tuberculosis J Comput Assist Tomogr 1997 21 254 258 Doherty FJ Ultrasound of the nonacute scrotum Semin Ultrasound CT MR 1991 12 131 156 Cassidy FH Ishioka KM McMahon CJ Chu P Sakamoto K Lee KS Aganovic L MR imaging of scrotal tumors and pseudotumors Radiographics 2010 30 665 683

On the ultrasonographic images, the right testis shows enlargement and inhomogeneous echogenecity. On the color Doppler images, the right testis shows increased vascularity (A). The enhanced CT scan reveals an enlarged right testis, which demonstrated inhomogenous density and necrotic foci (B).

The chest radiograph shows fibrocalcified nodules in both upper lobes (A). The chest CT reveals centrilobular nodules and a tree-in bud pattern in both upper lobes (B).

Pathologic examination demonstrats normal testicular tissue on the left lower corner, while with necrotizing granulomas and Langerhans cells (arrows) on the center (H&E stain, ×100).