An unusual case of genital filariasis of the testicular tunics in an Italian patient

Abstract

At least 27 million men present with urogenital manifestations of genital filariasis (GF). Although there is a large burden of GF in residents in endemic regions, infection in short-term travellers and in non-endemic areas is rare. We report the case of a 75-year-old Italian man referred to our institution for a testicular discomfort. Clinical examination and ultrasound detected a mass of 40×18 mm in the scrotum without signs of varicocele, hydrocele and testicular or epididymal abnormalities. After ineffective medical treatment, the patient underwent surgical excision. Histology demonstrated filarial granuloma with thick cuticles pathognomonic of an adult worm in the testicular tunics. Surgery has a fundamental role in localized cases of GF to remove nematodes from the fibrotic nodules. The present manuscript describes a singular case of GF observed in Italy in a non-immigrant patient with evidence of remnants of an adult worm in the testicular tunics. SIMILAR CASES PUBLISHED: 11.

Figure 1.. Scrotal ultrasound showing a 40×18 mm right scrotal isoechoic mass with internal vascularity, edema and light calcifications embedded just above the epididymis.

Figure 2.. The gross specimen measuring 25×20×15 mm.

Figure 3.. Histology after H&E staining (5×) showing fibroadipose tissue with chronic inflammatory eosinophilic infiltration, macrophages and isolated giant cells, associated with the presence of thick cuticles pathognomonic of a filarial worm.