Tuberculous Orchitis Mimicking Testicular Cancer: A Case Report and Literature Review

Abstract

Background: Tuberculous orchitis is a rare form of genitourinary tuberculosis that can closely mimic testicular malignancy, particularly in endemic regions. Its nonspecific clinical and radiological features often lead to delayed diagnosis and unnecessary orchidectomy. Case Presentation: We report the case of a 37-year-old man presenting with a four-month history of progressive, painless testicular cancer with pulmonary metastases, leading to the left inguinal orchidectomy. Histopathological examination, however, revealed granulomatous inflammation with caseating necrosis, consistent with tuberculous orchitis. The patient responded favorably to standard anti-tubercular therapy, with resolution of contralateral epididymal involvement within four weeks. Conclusion: This case highlights the diagnosis dilemma of testicular tuberculosis and emphasizes the critical role of histopathological examination in distinguishing it from malignancy. Clinicians should maintain a high index of suspicion for tuberculosis in atypical testicular masses in endemic regions, as timely medical therapy may prevent unnecessary surgery and preserve testicular function.