Korean J Urol.  2011 Apr;52(4):295-297.

Extensive Systemic Sarcoidosis with Testicular Involvement Mimicking Metastatic Testicular Cancer

• Kim YB
• Chung YG
• Kim SJ
• Kim SJ
• Ahn HS
• Joo HJ
• Kim SI

Abstract

Sarcoidosis is an idiopathic, multisystem disease that rarely involves the genitourinary tract. Here we present an unusual case of testicular sarcoidosis with extensive lymphadenopathy that mimicked a metastatic testicular tumor. A 27-year-old male presented with a palpable right testicular mass accompanied by multiple palpable inguinal lymph nodes. The scrotal ultrasound showed a hypoechoic lesion at the inferior portion of the right testis. Extensive enlarged lymph nodes were noted in multiple areas on the abdominal computed tomography. Preoperative testicular tumor markers were within the normal range. Exploration of the right testis with a frozen section analysis of the right testicular mass and of a palpable right inguinal lymph node showed granulomatous inflammation. The testis was salvaged and the final pathological diagnosis was sarcoidosis. Treatment with high-dose corticosteroids resulted in complete resolution of the intratesticular mass and a significant decrease in the extent of the lymphadenopathy.

Keyword

Lymphatic diseases; Sarcoidosis; Steroids; Testicular neoplasms; Testis

MeSH Terms

Adrenal Cortex Hormones
Adult
Frozen Sections
Humans
Inflammation
Lymph Nodes
Lymphatic Diseases
Male
Reference Values
Sarcoidosis
Steroids
Testicular Neoplasms
Testis
Biomarkers, Tumor
Adrenal Cortex Hormones
Steroids

Figure

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  FIG. 1 Scrotal ultrasound showing ill-defined, irregular, hypoechoic lesion at the inferior portion of the right testis (arrow).

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  FIG. 2 A 3D coronal image computed tomography scan of the abdomen after administration of intravenous contrast medium. (A) Extensive enlarged lymph nodes were seen in the retroperitoneal space. (B) Four months after the start of high-dose corticosteroid therapy, multiple, extensive retroperitoneal lymph nodes had considerably decreased in size.

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  FIG. 3 Histopathological examination of the intratesticular lesion showed non-caseating epithelioid cell granulomas with giant cells (H&E, ×200). (A) Testis. (B) Right superficial inguinal node.

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