Schistosomiasis presenting with testicular enlargement in elderly male

An eighty-eight-year-old Puerto Rican presented with painless enlargment of one testicle which proved histologically to be due to Schistosoma mansoni. Intratesticular ovum deposits were not associated with inflammation, granulomas, or infarction, but marked sclerosing periorchitis was present. The case illustrates a very rare form of presentation of schistosomiasis which should be considered in the differential diagnosis of unilateral testicular enlargement in patients from an endemic area, despite the fact that orchiectomy will usually be necessary to establish a definitive histopathologic diagnosis.