A case of xanthogranulomatous orchitis and its preoperative diagnostic challenges

Murshed, Khaled; Taha, Noheir M; Ben-Gashir, Mohamed

doi:10.1016/j.eucr.2020.101248

Cited by 4 publications

(12 citation statements)

References 4 publications

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“…XGEO is a rare disease process with a description of 38 cases reported in 29 articles in medical literature. [ 1 2 6 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 ] The details of demographics and clinical profile of the patients are summarized in Table 1 . Most of these cases have been reported from the Asian continent ( n = 18), followed by Europe ( n = 13), North America ( n = 3), Africa ( n = 2), and 1 case each from South America and Australia.…”

Section: Discussionmentioning

confidence: 99%

Xanthogranulomatous epididymo-orchitis

Vijayvergiya

Gulwani

Hasan

2023

Indian Journal of Urology

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Introduction: Xanthogranulomatous inflammation is a rare nonneoplastic and chronic inflammatory process, characterized by proliferation of foamy macrophages resulting in damage and necrosis of the affected tissue. Involvement of the testis/epididymis by the disease is a rare event. Methods: A case series of four male patients diagnosed with xanthogranulomatous epididymitis/orchitis (XGEO) at our institute was reviewed. In addition, a systematic review of XGEO was carried out using PRISMA Guidelines 2020. Twenty-nine articles describing 38 patients of XGEO were included in the study. Results: XGEO usually has a subacute or chronic presentation and affects male individuals in the 5th or 6th decades of life. The disease is also known to occur in the pediatric age group. The patients present with swelling, tenderness, or pain in the scrotal region. Bilateral involvement has also been documented. Thirty patients were known to have one or more causal risk factors including diabetes mellitus (23.7%), spinal cord injury/neuropathic bladder (7.9%), prostatectomy (7.9%), trauma (4.1%), and transurethral resection of prostate procedure (4.1%). Complications observed were scrotal fistula, adhesions, and abscess formation. Radiological features reported are nonspecific and include heterogeneous echotexture, hypoechoic areas, and/or scrotal wall collections. Bacterial microorganisms isolated from the affected tissue demonstrated the presence of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. Histological subtypes of XGEO are diffuse and focal. In the diffuse subtype, which is more common, there is extensive parenchymal destruction by inflammatory process accompanied by widespread ischemic necrosis. Conclusion: The mainstay of treatment in XGEO cases is surgical excision preferably orchidectomy. Conservative management has been attempted in young individuals and in patients with focal XGEO, but there is limited supporting evidence. We present data of four cases along with detailed systematic review of the disease examining its clinicopathological behavior and associated risk factors followed by operative approach.

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Section: Discussionmentioning

confidence: 99%

Xanthogranulomatous epididymo-orchitis

Vijayvergiya

Gulwani

Hasan

2023

Indian Journal of Urology

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“…A review of published cases demonstrated a predilection for this condition in the third to seventh decades of life [9] . XGO is a rare non-neoplastic destructive inflammatory condition of the testis that can result in a tumefactive lesion, mimicking malignant processes [10] . Young and elderly individuals are both susceptible to XGO.…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative diagnosis of XGO can be taxing due to the clinical and radiological overlap with testicular neoplasms. Both entities manifest with painless, tumefactive testicular enlargement and can generate the impression of a mass lesion on radiologic studies [10] . Imaging thus has negligible impact on the diagnosis of XGO [14] .…”

Section: Discussionmentioning

confidence: 99%

“…Preoperatively, elevated serum tumor biomarkers provide a clue to the diagnosis of testicular malignancy. However, serum tumor markers can be normal in some testicular neoplasms, making differentiation between the two disorders even more difficult and necessitating histopathologic examination of the resected tissue for definitive diagnosis [10] . The characteristic microscopic finding in XGO is the detection of aggregates of foamy histiocytes admixed with a heterogeneous inflammatory cell infiltrate, causing widespread destruction and effacement of the testicular parenchyma [10] .…”

Section: Discussionmentioning

confidence: 99%

“…However, serum tumor markers can be normal in some testicular neoplasms, making differentiation between the two disorders even more difficult and necessitating histopathologic examination of the resected tissue for definitive diagnosis [10] . The characteristic microscopic finding in XGO is the detection of aggregates of foamy histiocytes admixed with a heterogeneous inflammatory cell infiltrate, causing widespread destruction and effacement of the testicular parenchyma [10] . Histopathologic examination of the current case revealed extensive mixed inflammatory cell infiltration of the testicular parenchyma, rete testis, and epididymal tissue, as well as complete destruction of the seminiferous tubules, liquefactive necrosis, suppuration, extensive fibrosis, and accumulation of foamy histiocytes with multinucleated giant cells.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Xanthogranulomatous epididymo-orchitis: A case report with review of the literature

Bapir

Ali²,

Hussien

et al. 2022

International Journal of Surgery Case Reports

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Xanthogranulomatous orchitis: a case series

Sambhus,

Sharma,

Pai

et al. 2023

Int J Res Med Sci

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Xanthogranulomatous orchitis (XGO) is a sporadic disorder that has no definite aetiology and is a mimicker of several conditions, most significant of which are testicular neoplasms. We present a case series of three cases. The first case presented with swelling in his scrotum. The second case presented with similar symptoms and had prior history of trauma to the scrotum. Both cases were clinically diagnosed with testicular tumour. The third case was a referred case of left chronic orchitis with sinus tract. All three patients underwent high inguinal orchidectomy. Regardless of clinical work-up and diagnoses, upon histopathological evaluation, all three cases were diagnosed with XGO. This study explores the variety of risk factors and aetiologies that may result in XGO.

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A case of xanthogranulomatous orchitis and its preoperative diagnostic challenges

Cited by 4 publications

References 4 publications

Xanthogranulomatous epididymo-orchitis

Xanthogranulomatous epididymo-orchitis

Xanthogranulomatous epididymo-orchitis: A case report with review of the literature

Xanthogranulomatous orchitis: a case series

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