Department of Urology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo, 142-8555, Japan.
BMC Urol. 2021 Sep 3;21(1):120. doi: 10.1186/s12894-021-00886-5.
We report the case of a patient with syphilitic testicular gumma and vasculitis with adrenal failure due to chronic steroid use.
A 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.
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.
我们报告了一例梅毒引起的睾丸树胶肿和血管炎的病例，由于慢性使用类固醇，该患者并发肾上腺衰竭。
一名 63 岁男性因右侧眼球肿胀和双侧睾丸非常坚硬而就诊，这种情况已经持续了 2 年。睾丸肿瘤标志物阴性；梅毒检测阳性。影像学检查提示主动脉炎和双侧睾丸恶性肿瘤。患者因感染接受氨苄西林治疗，因血管炎接受泼尼松龙治疗。为了确认是否存在睾丸肿瘤，行左侧睾丸切除术；组织学检查显示肉芽肿性睾丸炎。由于类固醇使用的复发和不良反应，调整了泼尼松龙的剂量。不幸的是，由于血压控制不佳和肺炎，该患者在重症监护病房死亡。
这是一例罕见的梅毒引起的睾丸受累和血管炎病例。本报告表明拓宽睾丸坚硬的鉴别诊断的重要性。
