Xanthogranulomatous orchitis: Review of the published work, and report of one case

Abstract

Xanthogranulomatous reaction is rare begin disease affects many different organs, in clinical practice it is well known to affect kidney and gallbladder, but also affect male genital organs including (Testis, epididymis, and spermatic cord), we report a case 70-year old, diabetic patient presented with right scrotal swelling, had history of prior TURP, tumor markers was within normal range, ultrasound shows multiple hypo echoic lesions with moderate hydrocele, exploration done: pus found within tunica vaginalis, and destructed testicular tissue with necrosis, culture revealed (E.Coli), histopathology showed xanthogranulomatous orchitis.

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

“…Although the exact cause is yet unknown, ascending or hematogenous infection is thought to be the most common [8] . 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] .…”

“…One of the most prominent etiologic determinants in the pathogenesis of this process in the testis is obstruction of the epididymis or the urinary tract [11] . The blockage of the spermatic cord can be mechanical, as in individuals who have had a prostatectomy or transurethral prostate resection, or functional, as in patients with diabetes mellitus who have neuropathy or in patients with spinal cord damage [9] . Urinary tract infection has also been considered as an etiologic agent [12] .…”

“…Urinary tract infection has also been considered as an etiologic agent [12] . Due to the chronic nature of the condition and the frequent unscrupulous use of broad-spectrum antibiotic regimens prior to microbiologic analysis, pathogenic bacteria are seldom detected by urine culture in the majority of patients [9] . There have been a few XGO case reports in which Escherichia coli and Pseudomonas aeruginosa were cultured [3] .…”

Identifying the deceiver: the non-neoplastic mimickers of genital system neoplasms

“…Epididymal obstruction, urinary infection, testicular ischemia are thought to be involved in the etiology of the disease [ 22 ]. An increased coexistence with diabetes has also been observed [ 23 , 24 ]. In certain cases, urinary cultures may grow E. coli and P. aeruginosa , which may be suggestive of an infectious etiopathogenesis [ 22 ].…”

“…Moreover, XGO may coexist with testicular malignancies [ 25 ]. Radical orchiectomy can be performed for both definitive diagnosis and curative treatment [ 24 ].

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