Xanthogranulomatous orchitis (XGO) is a rare benign disease of the testis which has not been previously documented in tropical Africa. We report a case of a 24-year-old Nigerian man who presented with a painless left hemiscrotal swelling. Our clinical diagnosis was left testicular cancer. Testicular tumor markers were normal. At surgical exploration, we found a left testicular tumor. Histopathological examination of the specimen showed XGO of the left testis. He had left radical orchiectomy and left inguinal node dissection. He has remained stable 8 months after the treatment. Xanthogranulomatous orchitis cannot be distinguished clinically from testicular cancer unless by histopathological examination. Orchiectomy is the treatment of choice. However, in all patients and particularly young patients and those with a single testis, histopathological confirmation is suggested to avoid unnecessary radical orchiectomy, useless irradiation and ill-timed chemotherapy.
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