Testicular schistosomiasis: a case study

Abstract

Objective: To report a case of testicular schistosomiasis.

Design: Case study.

Setting: University hospital.

Patient(s): A 26-year-old unmarried Egyptian man presented with slowly growing painless swelling at the right hemiscrotum.

Interventions: Physical examination, scrotal ultrasonography, magnetic resonance imaging (MRI), computerized tomography, urine and semen Zeihl-Neelsen stain, stool, serum alpha-fetoprotein, FSH, LH, PRL, E2, total testosterone (T), and surgical exploration.

Main outcome measure(s): Clinical, laboratory, radiologic, and histopathologic data.

Result(s): At clinical examination, there was a large painless swelling in the right hemiscrotum with two hard masses felt subcutaneously. The transillumination test was negative with no inguinal lymphadenopathy. The left hemiscrotum revealed normal findings. Serum alpha-fetoprotein, FSH, LH, total T, E2, and PRL were within normal. MRI demonstrated no masses of abnormal signal intensity or enhancement. Scrotal surgical exploration revealed discharge of thick brownish red pus with presence of two hard extratesticular scrotal masses. Histopathology of the right testis biopsy revealed reduced diameter of the seminiferous tubules with marked hypospermatogenesis where the interstitium was filled by multiple Schistosoma mansoni ova associated with granulomatous reaction compressing the tubules.

Conclusion(s): Scrotal involvement in schistosomiasis with its variable presentations should be considered in diagnosing scrotal masses, especially in endemic areas.