Granulomatous orchitis

Three cases of an uncommon but extremely interesting inflammatory process are reported. As our discussion indicates, many questions remain unanswered. It is important to recognize this condition because it is often initially thought to be neoplastic. The disease is characterized by acute recurring exacerbations over a long period and is often associated with urinary tract infections or trauma. The testis is almost always extremely firm and frequently enlarged and tender. We believe that orchiectomy is indicated in most instances, except in extremely young individuals and those in whom the only remaining testicle is involved. Biopsy is probably sufficient in the latter case unless symptoms persist. The final diagnosis must rest on the exclusion of other granulomatous diseases as well as the microscopic picture.