JMCR: Clinical Minute

Testicular malakoplakia in a middle-aged Han Chinese male: a case report and review of the literature

Published in Biomedical Research

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Article Summary

Testicular malakoplakia in a middle-aged Han Chinese male: a case report and review of the literature describes a rare inflammatory condition that closely mimics testicular cancer.

A 41-year-old man presented with right testicular swelling, fever, dysuria, and Escherichia coli urinary tract infection. Ultrasound, contrast-enhanced ultrasound (CEUS), CT, and MRI all suggested a testicular neoplasm. Despite antibiotic therapy, symptoms persisted, and the patient underwent radical orchiectomy. Histopathology demonstrated characteristic Michaelis–Gutmann bodies, confirming testicular malakoplakia.

The report is the first to describe the CEUS appearance of testicular malakoplakia, demonstrating rapid, intense enhancement followed by slow washout. Although these findings initially resembled malignancy, the delayed washout may represent a potential imaging clue to distinguish this rare inflammatory disease from testicular cancer. The authors emphasize that definitive diagnosis currently depends on pathological examination and that radical orchiectomy remains the standard approach when malignancy cannot be excluded.

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