Revision 2 for 'Testicular sarcoidosis'

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Testicular sarcoidosis

Testicular sarcoidosis is a rare manifestation of sarcoidosis. In cases of urogenital sarcoidosis more commonly it is the epididymis that is affected.

Epidemiology

Testicular sarcoidosis is more common in African-American patients, as are other forms of sarcoidosis 1. Up to 5% of patients with chronic sarcoidosis have evidence of testicular disease on autopsy 2.

Clinical presentation

Patients may be asymptomatic or present with pain or a mass 2.

Radiographic features

Testicular sarcoidosis should be considered in cases where there are multiple masses in the testis and epididymis 3

Ultrasound

On ultrasound enlarged epipidymides and multiple nodules with decreased echogenicity can be expected 2

MRI

Expected findings on MRI include 2:

  • T1 Gd (C+)

    • enlarged epididymides
    • may be unilateral and solitary however;
    • more often are multiple, small, bilateral nodular lesions 
    • enhancing with contrast
  • T2: as above however lesions show low signal intensity

Treatment and prognosis

Excluding a testicular malignancy and preserving fertility are the main goals of treatment 1.

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