Testicular Sarcoidosis: An Underdiagnosed Manifestation That Poses Unique Challenges

Abstract

Testicular involvement is a rarely encountered complication of sarcoidosis. There are unique challenges involved when sarcoidosis affects the genitourinary system. These include differentiating the findings from testicular cancer, which often results in invasive procedures such as orchiectomies. It can also be a cause of secondary infertility in men. Additionally, it may also be underdiagnosed. Here, we describe a case where a patient showed a constellation of findings suggestive of sarcoidosis, along with testicular involvement at initial presentation. In this case, the diagnosis was made clinically with supporting laboratory, pathology, and ultrasound findings. The testicular findings were not biopsied, as the patient had easily accessible skin findings to confirm sarcoidosis. His testicular findings are continued to be monitored via ultrasound.

Keywords: hilar lymphadenopathy; lung nodules; sarcoidosis; testicular cancer; testicular lesion.

Figure 1. Testicular ultrasound showing typical hypoechoic lesion (with yellow arrow) in the patient.

Figure 2. High-resolution CT scan showing a typical pattern of bronchiectasis with a tram track sign is seen in the image (orange arrow).

Additionally, micronodules and non-specific ground-glass opacities are seen (green arrow).