Limited Wegener’s granulomatosis of the epididymis and testis

Shang-sen lee¹, Shou-Hung Tang¹, Guang-Huan Sun¹, Cheng-Ping Yu², Jong-Shiaw Jin2, sun-Yran Chang<sup>1

1</sup>Division of Urology, Department of Surgery, ²Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, National Defense University, Taipei, Taiwan, China

DOI: 10.1111/j.1745-7262.2006.00207.x

Abstract
A case is presented of Wegener's granulomatosis limited to the testis and epididymis, simultaneously, in a 69-year-old man. Orchiectomy was carried out through an inguinal incision under the presumptive diagnosis of a right testicular tumor. A hard, irregular mass occupied the upper testicle and a portion of the epididymal head was visualized. Histopathologic examination of the specimen showed granulomatous inflammation of the testis and epididymis with prominent angiocentric granulomata in the walls of arteries, veins and foci of fibrinoid necrosis, surrounded by palisading inflammatory cells with a few giant cells. The diagnosis of limited Wegener’s granulomatosis was considered, although antineutrophil cytoplasmic antibody (c-ANCA) test was negative 2 weeks after orchiectomy. The patient showed an excellent response after local complete excision. He remains free of disease 18 months after orchiectomy.

Keywords: Wegener’s granulomatosis; testis; epididymis

Correspondence to: Dr Guang-Huan Sun, Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec 2, Cheng-Gung Rd, Nei-Hu, Taipei, Taiwan 114, China
Tel: +886-8792-7020, Fax: +886-8792-7168
E-mail: ghsun@ndmctsgh.edu.tw
Received 2006-02-31 Accepted 2006-04-20