Hard bilateral syphilitic testes with vasculitis: a case report and literature review

Sat Prasad Nepal,Moyuru Mizunuma,Yoshiki Tsunokawa,Yoshihiro Nakagami,Takehiko Nakasato,Takashi Fukagai,Yoshiko Maeda,Satoshi Amano,Jun Morita,Yoshio Ogawa,Masahiro Kurokawa,Takeshi Shichijo,Ryosuke Kato,Tatsuki Inoue,Tsutomu Unoki,Sou Yasuda,Tetsuo Noguchi,Kazuhiko Oshinomi

doi:10.1186/s12894-021-00886-5

Abstract

BackgroundWe report the case of a patient with syphilitic testicular gumma and vasculitis with adrenal failure due to chronic steroid use.Case presentationA 63-year-old male presented with hard right eye swelling and very firm bilateral testes on palpation, which he had for 2 years. Testicular tumor markers were negative; syphilis test was positive. Radiological examination suggested aortitis and bilateral testicular malignancy. The patient received ampicillin for the infection and prednisolone for vasculitis. Left orchidectomy was performed to confirm the presence of testicular tumor; histological examinations revealed granulomatous orchitis. The prednisolone doses were adjusted because of relapses and adverse effects of steroid use. Unfortunately, the patient died in the intensive care unit because of uncontrolled blood pressure and pneumonia.ConclusionsThis is a rare case of syphilis with testicular involvement and vasculitis. This report shows the importance of broadening the differential diagnoses of testicular firmness.

Highlights

We report the case of a patient with syphilitic testicular gumma and vasculitis with adrenal failure due to chronic steroid use.Case presentation: A 63-year-old male presented with hard right eye swelling and very firm bilateral testes on palpation, which he had for 2 years
This is a rare case of syphilis with testicular involvement and vasculitis
This report shows the importance of broadening the differential diagnoses of testicular firmness

Summary

Introduction

We report the case of a patient with syphilitic testicular gumma and vasculitis with adrenal failure due to chronic steroid use.Case presentation: A 63-year-old male presented with hard right eye swelling and very firm bilateral testes on palpation, which he had for 2 years. Conclusions: This is a rare case of syphilis with testicular involvement and vasculitis. This report shows the importance of broadening the differential diagnoses of testicular firmness. Background Syphilis involvement in the testis is extremely rare, and the literature has very few case reports. Testicular gummata are characterized by multiple swellings in the testis and granulomatous inflammation with a billiard ball-like hard consistency [1].

Results

Conclusion