Authors : Dr. Appana Sriram Eswar; Dr. B. K. Durga Prasad; Dr. A. Bhagyalakshmi; Dr. N. C. A. Narsimharao; Dr. Akanksh Chokkapu; Dr. B. Neeraj Vasishta Banavat

Volume/Issue : Volume 11 - 2026, Issue 4 - April

Google Scholar : https://tinyurl.com/5a939j34

Scribd : https://tinyurl.com/mpjudet9

DOI : https://doi.org/10.38124/ijisrt/26apr473

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Background: Urogenital tuberculosis (UGTB) accounts for 8–15% of extrapulmonary TB. Isolated tuberculous epididymo-orchitis without renal involvement is rare and poses a significant diagnostic challenge, as its clinical and imaging features closely mimic testicular malignancy. Misdiagnosis may lead to unnecessary orchiectomy.  Case Presentation: A 19-year-old, sexually inactive male presented with a one-year history of progressive painful scrotal swelling, intermittent low-grade fever, and multiple discharging sinuses. Ultrasonography demonstrated diffusely enlarged, heterogeneously hypoechoic testes with epididymal involvement, scrotal wall thickening, and inguinal lymphadenopathy with central necrosis. HRCT chest revealed endobronchial spread with centrilobular nodules and a right upper lobe cavity. Histopathological examination of sinus tract aspirate confirmed tuberculous granulomatous inflammation. The patient was started on anti-tubercular therapy with clinical improvement.  Conclusion: Tuberculous epididymo-orchitis should be considered in the differential diagnosis of testicular masses, particularly in TB-endemic regions. Key imaging clues favoring an inflammatory etiology over neoplasm include epididymal involvement, sinus tract formation, scrotal wall thickening, and necrotic lymphadenopathy. Awareness of these radiologic features can help avoid unnecessary surgical intervention.

Keywords : Tuberculous Epididymo-Orchitis; Testicular Malignancy Mimic; Scrotal Ultrasonography; Urogenital Tuberculosis; Diagnostic Pitfall.

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