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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.



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


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


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.


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.

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