Beyond the Swelling: A Missed Foreign Body in the Testis

Intratesticular foreign bodies are rare. We present the case of a young man who, three months after experiencing scrotal trauma, was evaluated for a suspected intratesticular foreign body. The incident occurred during the use of a wire brush attached to a grinder, likely resulting in the penetration of a small metallic fragment into the scrotal wall and testicular tissue. Initial ultrasound imaging was inconclusive, and the patient was treated empirically with antibiotics. Although his symptoms resolved over time, ongoing concern led to multiple follow-up visits. A third ultrasound performed approximately 12 weeks post-injury revealed a linear, hyperechoic structure, raising suspicion for a retained foreign body and prompting surgical referral. Upon admission, the patient was asymptomatic, and physical examination revealed only a small, firm nodule in the left testis. Surgical exploration confirmed the presence of a thin metallic wire, which was removed without complications. This case illustrates the diagnostic difficulty of identifying retained intratesticular foreign bodies when early imaging is non-diagnostic and symptoms subside. It emphasizes the value of repeated high-resolution ultrasonography in cases with a suggestive clinical history.