Acute orchitis or a mass in testis usually evokes a neoplasm, a torsio
n or infectious disease for the clinician. Rarely, a systemic disease
is involved. Nethertheless, testicular involvement occurs during vascu
litis, Behcet or granulomatous diseases, but is uncommonly the first m
anifestation. Histologic changes after biopsy or orchiectomy usually g
ive the diagnosis. Testicular localization of systemic disease does no
t change the general treatment.