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Urology. 2011 May;77(5):1043-8. doi: 10.1016/j.urology.2011.01.021. Epub 2011 Mar 17.

Testicular vasculitis: a series of 19 cases.

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  • 1Department of Pathology, McGill University Health Center, Montreal, Canada.

Abstract

OBJECTIVES:

Because of limited reported cases, it is unknown how often testicular vasculitis represents isolated or systemic disease.

METHODS:

We report 19 cases (15 consultation; 4 in-house cases) of localized testicular infarction with associated vasculitis spanning 24 years.

RESULTS:

All were orchiectomy specimens; detailed clinical information was available in 16 cases. Mean age was 38 years. Clinical presentation was testicular pain in 13 and mass in 3 patients. Preoperative impression was testicular cancer in 13 cases. In all cases, localized testicular infarction associated with vasculitis was present and in none was tumor identified. Most cases (n = 14) showed polyarteritis nodosa (PAN)-like features with transmural necrotizing inflammation of small-medium arteries. In 4 cases, vasculitis was granulomatous (2 necrotizing; 2 non-necrotizing) and in 1 case was lymphocytic. An infectious etiology was excluded clinically and by special stains. Four patients were subsequently confirmed with systemic vasculitis: one with PAN, one with Wegener vasculitis, one with vasculitis not otherwise specified and one with subclinical systemic vasculitis. Two of those 4 patients had testicular PAN-like vasculitis and 2 had granulomatous vasculitis.

CONCLUSIONS:

Testicular vasculitis can cause localized infarction that clinically mimics cancer. Although testicular vasculitis is an isolated finding in most patients an associated systemic vasculitis is not a rare event (4/16, or 25%), especially if the vasculitis is granulomatous (50% in this series). All patients should be clinically investigated for systemic disease.

Copyright © 2011 Elsevier Inc. All rights reserved.

PMID:
21419476
[PubMed - indexed for MEDLINE]
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