FOCAL TESTICULAR VASCULITIS - TESTICULAR MANIFESTATIONS OF IMMUNOLOGICAL DISORDERS IN DIFFERENTIAL-DIAGNOSIS OF TESTICULAR CANCER

We report on the case of a 31-year-old male patient with focal testicu lar vasculitis as the only clinical manifestation of endangiitis oblit erans (Winiwarter-Buerger disease), who presented with acute scrotal p ain and swelling suggestive of a testicular tumor. Dopplersonography r evealed significantly increased vascularization at the borders of the lesion, which rather indicated a vascular process; however, the presen ce of solid areas meant that the possibility of testicular cancer coul d not be excluded. Left inguinal orchiectomy was performed. The surgic al specimen revealed histological patterns compatible with endangiitis obliterans; Raynaud phenomenon was the only sign of systemic disease, and no other organs were found to be affected. Despite the high sensi tivity and specificity of ultrasound/Doppler sonography, in the differ ential diagnosis of an unexplained testicular mass surgical exploratio n is still mandatory. The different types of focal vasculitis are desc ribed and discussed with reference to the literature.