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Updated: Jun 25, 2026
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Published on: March 31, 2023
Isolated tuberculous epididymitis masquerading as a scrotal tumor
Wei-Chieh Miu1, Hui-Ming Chung, Yung-Cheng Tsai
1Department of Infection, Mennonite Christian Hospital, Hualien, Taiwan.
Summary
Tuberculosis can mimic scrotal tumors. A man with a testicular mass was diagnosed with tuberculous epididymitis after surgery, highlighting the importance of considering infection in differential diagnoses.
Area of Science:
- Urology
- Infectious Diseases
- Pathology
Background:
- Scrotal masses can present diagnostic challenges, with neoplastic and infectious etiologies requiring careful differentiation.
- Isolated tuberculous epididymitis is rare, often presenting with non-specific symptoms that can be mistaken for other conditions.
Observation:
- A 65-year-old male presented with a rapidly growing, painless right scrotal mass, initially suspected as an epididymo-testicular tumor.
- Initial investigations including tumor markers, urinalysis, and imaging were inconclusive for malignancy but revealed a testicular tumor with hydrocele.
Findings:
- Post-orchiectomy pathology confirmed tuberculous epididymitis as the cause of the scrotal mass.
- Despite negative urine mycobacterial cultures, the diagnosis was established and successfully treated with anti-tuberculosis medication.
Implications:
- This case underscores the necessity of including tuberculosis in the differential diagnosis of scrotal masses, even in the absence of typical systemic signs.
- Early recognition and appropriate anti-tuberculosis therapy are crucial for favorable outcomes in patients with tuberculous epididymitis presenting as a scrotal tumor.
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