Xanthogranulomatous Orchitis: A Case Report of a Rare Entity Affecting the Male Gonad

Xanthogranulomatous orchitis (XGO) is an uncommon chronic inflammatory condition that is characterized by testicular tissue destruction and macrophage infiltration, with a limited number of documented cases in the literature. We present a case study of a 52-year-old gentleman who initially presented with symptoms consistent with epididymo-orchitis, but later required orchiectomy due to non-viability of the right testis on Doppler ultrasound. Subsequent histopathological examination led to a diagnosis of XGO. The etiology of XGO remains unclear; however, it is speculated that infections, particularly E. coli, and epididymal obstruction contribute to its pathogenesis. The differentiation of XGO from testicular tumors poses a clinical challenge, as pre-operative diagnostic methods are inadequate, necessitating surgical excision for definitive diagnosis and treatment. This report emphasizes the rarity of XGO, its diagnostic complexities, and the significance of recognizing this condition in the context of differential diagnoses in testicular pathology.