Filarial granuloma of the testicular tunic mimicking a testicular neoplasm: a case report

A 32-year-old man presented with a history of noticing a swelling in his right testicle for a period of 1 month which had become painful over the 10 days before presentation. Pre-operative imaging failed to shed light on the nature of the lesions (malignant or benign). The diagnostic dilemma was explained to the patient and informed consent was obtained for an orchiectomy. The patient underwent a high inguinal orchiectomy. The histopathology revealed a filarial granuloma of the testicular tunic.While it is generally regarded that any testicular swelling, especially in a young person, should be treated as a malignancy unless proven otherwise, it is important to remember that infectious diseases such as filariasis and tuberculosis may mimic neoplasms. Careful consideration of these diagnoses must be given when dealing with testicular swellings especially in areas where the prevalence of these diseases is high.Lymphatic filariasis is a major health problem in India with a large number of patients tending to be asymptomatic. Genital filariasis in India more commonly presents as a secondary vaginal hydrocele with an associated epididymo-orchitis. While testicular involvement is rare, the discovery of an adult worm in the testicular tunics has not been reported previously. We thus outline this unique presentation of testicular filariasis.A 32-year-old man presented with a history of noticing a swelling in his right testicle over a period of 1 month but which had become painful over the 10-day period before presentation. The patient was afebrile and had not suffered any trauma to the testes. Examination of the genitalia revealed a mild enlargement of the right testicle with a palpable ill-defined tender 1 cm × 1 cm nodule at the lower pole of the right testis. The epididymis and spermatic cord were normal to palpation. The left testis and cord were normal. Complete blood count, including the differential count, was normal (no eosinophilia). His chest X-ray was normal. Test