Polyarteritis nodosa with bilateral asynchronous testicular necrosis: a case report

Area of Science:

• Vascular Medicine
• Rheumatology
• Urology

Background:

• Polyarteritis nodosa (PAN) is a systemic vasculitis affecting medium-sized arteries.
• PAN can lead to organ damage through thrombosis or aneurysm formation.
• Testicular involvement in PAN is uncommon.

Observation:

• A 55-year-old male presented with acute left testicular pain, leading to orchiectomy.
• Three weeks later, he developed right testicular necrosis, requiring a second orchiectomy.
• The patient also experienced abdominal skin necrosis, penile symptoms, and transient vision loss.

Findings:

• Pathologic evaluation revealed benign testes with acute interstitial hemorrhage and focal atrophy.
• Bilateral asynchronous testicular necrosis was confirmed.
• No evidence of testicular torsion was found in the initial presentation.

Implications:

• This case represents the first reported instance of asynchronous testicular necrosis due to PAN.
• It underscores the diverse and severe manifestations of PAN, even in rare presentations.
• Highlights the importance of considering systemic vasculitis in unexplained testicular emergencies.