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Polyarteritis nodosa mimicking a testis tumour: a case report and review of the literature

View Article: PubMed Central

ABSTRACT

A 28-year-old man presented with a seven-day history of testicular pain. Physical examination revealed a mass in the lower pole of the left testis. This mass was a tumour suspect on scrotal ultrasound and MRI. Testicular tumour markers were negative. A radical orchidectomy was performed. Histologically, the diagnosis of polyarteritis nodosa (PAN) was made. Retrospectively, the diagnosis of PAN could have been made earlier. The patient was treated for superficial thrombophlebitis in the months prior to admission. This was considered to be a paraneoplastic phenomenon after radical nephrectomy for a conventional type renal cell carcinoma two years earlier. After the diagnosis of PAN was made on the orchidectomy specimen, the cutaneous lesions were finally recognized as cutaneous PAN. With this knowledge, a simple testicular biopsy could have avoided a radical orchidectomy. A short review of literature on testicular PAN is given.

No MeSH data available.


Related in: MedlinePlus

Axial T2-weighted images of the scrotum. An ill-marginated hypointense area is seen in the lower pole of the left testis. Small hydrocele.
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Fig1: Axial T2-weighted images of the scrotum. An ill-marginated hypointense area is seen in the lower pole of the left testis. Small hydrocele.

Mentions: A 28-year-old white man presented with a seven-day history of left testicular pain. Prior to the present hospitalisation, the patient was treated with antibiotics by his general practitioner for presumed epididymitis. Physical examination revealed a painful mass in the lower pole of the left testis. Further investigation was unremarkable. A scrotal ultrasound confirmed a hypoechogenic mass in the lower pole of the left testis. CT scan of the abdomen and thorax showed no metastases or lymph nodes. MRI confirmed an area of heterogeneous parenchyma in the lower pole of the left testis, without invasion in the tunica albuginea. In addition, a mild hydrocoele was present (Fig. 1). Complete blood count, blood urea nitrogen, creatinine, liver function tests and Hepatitis B surface antigen were normal. Testicular tumour markers were negative: beta human chorionic gonadotropin level was less than 1.0 U L−1 (normal 0.0–5.0), alpha-fetoprotein level was 6 µg L−1 (normal 0–20). C-reactive protein (CRP) was slightly elevated to 14.4 mg L−1.Figure 1


Polyarteritis nodosa mimicking a testis tumour: a case report and review of the literature
Axial T2-weighted images of the scrotum. An ill-marginated hypointense area is seen in the lower pole of the left testis. Small hydrocele.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4554691&req=5

Fig1: Axial T2-weighted images of the scrotum. An ill-marginated hypointense area is seen in the lower pole of the left testis. Small hydrocele.
Mentions: A 28-year-old white man presented with a seven-day history of left testicular pain. Prior to the present hospitalisation, the patient was treated with antibiotics by his general practitioner for presumed epididymitis. Physical examination revealed a painful mass in the lower pole of the left testis. Further investigation was unremarkable. A scrotal ultrasound confirmed a hypoechogenic mass in the lower pole of the left testis. CT scan of the abdomen and thorax showed no metastases or lymph nodes. MRI confirmed an area of heterogeneous parenchyma in the lower pole of the left testis, without invasion in the tunica albuginea. In addition, a mild hydrocoele was present (Fig. 1). Complete blood count, blood urea nitrogen, creatinine, liver function tests and Hepatitis B surface antigen were normal. Testicular tumour markers were negative: beta human chorionic gonadotropin level was less than 1.0 U L−1 (normal 0.0–5.0), alpha-fetoprotein level was 6 µg L−1 (normal 0–20). C-reactive protein (CRP) was slightly elevated to 14.4 mg L−1.Figure 1

View Article: PubMed Central

ABSTRACT

A 28-year-old man presented with a seven-day history of testicular pain. Physical examination revealed a mass in the lower pole of the left testis. This mass was a tumour suspect on scrotal ultrasound and MRI. Testicular tumour markers were negative. A radical orchidectomy was performed. Histologically, the diagnosis of polyarteritis nodosa (PAN) was made. Retrospectively, the diagnosis of PAN could have been made earlier. The patient was treated for superficial thrombophlebitis in the months prior to admission. This was considered to be a paraneoplastic phenomenon after radical nephrectomy for a conventional type renal cell carcinoma two years earlier. After the diagnosis of PAN was made on the orchidectomy specimen, the cutaneous lesions were finally recognized as cutaneous PAN. With this knowledge, a simple testicular biopsy could have avoided a radical orchidectomy. A short review of literature on testicular PAN is given.

No MeSH data available.


Related in: MedlinePlus