結核感染模仿陰囊腫瘤之病例報告 

謝棨圳¹、錢祖明²

¹高雄醫學大學附設中和紀念醫院泌尿部

Tuberculosis Infection Mimics Scrotal Tumor: A Case Report

Chi-Chun Hsieh¹, Tsu-Ming Chien²

¹Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

²Department of Urology, Kaohsiung Medical University Gangshan Hospital, Kaohsiung, Taiwan

Abstract:

Background: Urogenital tuberculosis (UGTB) is a form of extrapulmonary tuberculosis (TB) that primarily affects the kidneys, ureters, bladder, and male or female reproductive organs. Scrotal tuberculosis is a rare manifestation of genitourinary tuberculosis. We report a case of scrotal tuberculosis mimics tumor in scrotum

Cases Presentation: A 60-year-old female with a history of hypertension and otitis media. He presented with enlargement of right inguinal mass for weeks without redness and tenderness. Sonography showed suspicious spermatic cord tumor. Tumor marker survey revealed all α-FETO PROTEIN, β-HCG and LDH (lactate dehydrogenase) within normal range. Computed tomography (CT) revealed ring form enhanced cystic lesions in the right scrotum. He then received scrotal tumor excision. Microscopically, tumor showed caseating granulomatous formation with central necrosis surrounded by rims of inflammatory cells, histiocytes, and fibroblastic proliferation. Numerous multinucleated giant cells were seen. No specific pathogen is revealed by Periodic acid-Schiff (PAS), Grocott methenamine-silver (GMS) and acid-fast stains. Urine and wound culture collected during operation showed Mycobacterium tuberculosis complex. Further sputum culture revealed Mycobacterium abscessus. The patient then received treatment with Rifampin (RMP), Ethambutol (EMB) and Pyrazinamide (PZA) for 9 weeks, followed by RMP and Isoniazid (INH) for 19 weeks. He is now under regular follow-up.