Testicular schistosomiasis : A case report from an endemic country

Abstract

Background

Schistosomiasis is an endemic parasitic disease in Madagascar. The urogenital form is mainly caused by Schistosoma haematobium. Testicular involvement is rare, particularly in children, and may mimic a testicular tumor.

Case Presentation

We report the case of an 8-year-old boy presenting with chronic right testicular pain. Imaging suggested a pseudotumoral lesion, leading to orchiectomy. Histopathological examination revealed inflammatory granulomas with schistosome eggs, confirming testicular schistosomiasis.

Discussion

Testicular schistosomiasis is exceptional but should be considered in endemic regions. The granulomatous reaction surrounding schistosome eggs results in progressive fibrosis of the testicular parenchyma, explaining the misleading clinical presentation. Histopathology is essential for diagnosis and differentiation from testicular tumors. Awareness of this entity is crucial to consider conservative diagnostic and therapeutic approaches when appropriate.

Conclusion

In endemic regions, testicular schistosomiasis must be included in the differential diagnosis of any testicular mass in children to prevent unwarranted surgical procedures and to ensure early initiation of antiparasitic treatment.