PMC6319168_01
Initial sonographic findings were suggestive of orheoepididymitis.
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The testis was well perfused and in normal position (Fig. 1).
On re-examination a week later, edema had subsided and the testis appeared hard, indurated and painless.
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On first reexamination, a week later, edema had subsided and the testis appeared hard, indurated and painless (Fig. 2).
Five days later another ultrasound showed reduced testicular perfusion that reached only the periphery of the testicular parenchyma.
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Five days later, at the second reexamination, another ultrasound showed reduced testicular perfusion that reached only the periphery of the testicular parenchyma (Fig. 3).
Intraoperatively testis was non-twisted, with normal vas and vessels that ended in a necrotic testicular parenchyma.
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The testis was dark brown, hard on palpation and no blood came out when incised (Fig. 4).
Spermatic granuloma: accumulation of sperm (center) surrounded by a granulomatous foreign body inflammatory response (upper part). H-EX 100.
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Histology showed a case of epididymitis nodosa and ruptured sperm granuloma that caused vascular compression, thrombosis and testicular necrosis (Fig. 5).