一位萊特氏症候群患者身上的睪丸內血腫：Sulfasalazine罕見的藥物副作用

張家郡¹、陳汶吉^1,2、林維卿³、黃志平^1,4

中國醫藥大學附設醫院泌尿部¹; 中國醫藥大學中醫學院中西醫結合研究所²;中國醫藥大學附設醫院醫學影像部³ ; 中國醫藥大學醫學系泌尿學科⁴

Intratesticular Hematoma in a Patient with Reiter’s Syndrome: An Unusual Side Effect of Sulfasalazine

Jia-Jyun Jhang¹, Wen-Chi Chen^1,2, Wei-Ching Lin³, Chi-Ping Huang ^1,4

¹Department of Urology, China Medical University Hospital, Taichung, Taiwan ² Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taiwan ³Department of Radiology, China Medical University Hospital, Taichung, Taiwan ⁴ School of Medicine, College of Medicine, China Medical University, Taiwan

Introduction: Spontaneous intratesticular hemorrhage is extremely rare without previous trauma history or risk factors. We report a patient with spontaneous intratesticular hematoma without trauma history who has been treated with sulfasalazine for Reiter’s syndrome.

Case presentation: We present a 28-year-old male patient suffering from sudden onset of a painful swelling of left testis. He did not have any trauma history. He has Reiter’s syndrome under treatment with sulfasalazine, non-steroidal anti-inflammatory drugs and acetaminophen. Scrotum sonography demonstrated a mixed-echoic mass in his right testis. Malignant testis tumor was suspected due to scrotum echo finding and radical orchidectomy was suggested. The patient hesitated about the operation and when he finally made the decision to receive the operation it was about 6 weeks after the discovery of the testis mass. Series images including ultrasonography and computed tomography during observation period revealed a hematoma, operation was then canceled. He preserved his testis from a suspicious malignancy to diagnosis of hematoma during a waiting period of operation.

Discussion: Previous reports of spontaneous intratesticular hematoma are mostly diagnosed after orchidectomy because its image finding may mimic that of malignant testicular tumors. The patient denied possible recent trauma, sexual activity, or other possible related medical interventions can cause hematoma. Nor does CT reveal other possible secondary cause of his hematoma. Due to there was no other related factor contributed to this hematoma and possible of hematological side effect of sulfasalazine, we therefore defer this may be due to a rare side effect of sulfasalazine.