A patient with testicular pseudolymphoma – a rare condition mimicking malignancy: a case report
© Ganzer et al; licensee BioMed Central Ltd. 2007
Received: 15 March 2007
Accepted: 25 August 2007
Published: 25 August 2007
Three months following a right sided acute epididymitis a 62 year old patient presented with a painless right testicular swelling. Physical examination, scrotal ultrasound and operative exploration suggested malignancy. However, after inguinal orchiectomy a benign pseudolymphoma of the testis was revealed by pathological examination. A pseudolymphoma is a rare benign lesion which can only be distinguished from a malignant lymphoma by immuno-histochemistry and molecular-genetical investigation techniques.
Testicular cancer presents in 5% of all urological tumours with 3 to 6 new cases occurring per 100000 per year . Testicular germ cell tumours have a peak incidence in the 3rd and 4th decade, but also occur in the elderly. Testicular cancer generally appears as a painless intrascrotal mass and is usually diagnosed by physical examination and scrotal ultrasound. In case of a suspected testicular mass the patient must undergo inguinal exploration. If a tumour is found, orchiectomy with resection of the spermatic cord is performed and the specimen sent for pathological examination. Benign lesions of the testis which appear to be malignant on physical examination and scrotal ultrasound are rare. We describe the case of a patient who underwent inguinal orchiectomy of a suspected malignant tumour, which finally showed to be a pseudolymphoma of the testis, a rare benign lesion mimicking features of malignancy.
A history of painless testicular swelling in combination with inhomogeneous parenchyma on ultrasound beside the intraoperative aspect described above is highly suspicious for testicular cancer. Even in the case of not elevated tumour markers a classical seminoma or a non germ – cell tumour including malignant lymphoma may be present. Therefore, surgery was indicated in this case and a wait and see strategy would not have been justifiable. However, our case demonstrates that in rare conditions chronic inflammatory pseudotumours may mimic typical presentations of testicular malignancy and particularly in post inflammatory conditions have to be included in the differential diagnosis.
A pseudolymphoma of the testis is a rare condition mimicking malignancy which occurs after chronic inflammation and has to be included in the differential diagnosis of painless testicular swelling.
Full written consent has been obtained from the patient for submission of this manuscript for publication. Funding was neither sought nor obtained.
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