Contrast-enhanced ultrasound for rare testicular tuberculosis

Testicular tuberculosis is a rare form of genital tuberculosis. Ultrasound is a crucial tool for evaluating male genital disorders. Contrast-enhanced ultrasonography (CEUS), which provides real-time monitoring of microvascular hemodynamics, provides rich information about microcirculation, helping distinguish testicular tuberculosis from other testicular conditions such as tumors and inflammation. This study reports on a rare case of testicular tuberculosis diagnosed through CEUS. A 31-year-old male patient presented with two months of persistent right scrotal pain and swelling. Conventional scrotal ultrasound showed an enlarged right testicle with heterogeneous echogenicity and abundant color Doppler blood flow signals. CEUS demonstrated rapid contrast agent filling in the right testicle, followed by the appearance of several irregular regions, indicating perfusion deficits in these areas. Histopathological confirmation through ultrasound-guided biopsy revealed granulomatous inflammation with caseous necrosis, which is consistent with the diagnosis of testicular tuberculosis. As a real-time monitoring technique for microvascular hemodynamics, CEUS provides valuable microcirculatory information that enhances diagnostic accuracy and enables the formulation of appropriate treatment plans for testicular tuberculosis versus other testicular pathologies.