PDF(Pubmed)
Abstract：
BACKGROUND: We report the case of a patient with syphilitic testicular gumma and vasculitis with adrenal failure due to chronic steroid use.
METHODS: A 63-year-old male presented with hard right eye swelling and very firm bilateral testes on palpation, which he had for 2 years. Testicular tumor markers were negative; syphilis test was positive. Radiological examination suggested aortitis and bilateral testicular malignancy. The patient received ampicillin for the infection and prednisolone for vasculitis. Left orchidectomy was performed to confirm the presence of testicular tumor; histological examinations revealed granulomatous orchitis. The prednisolone doses were adjusted because of relapses and adverse effects of steroid use. Unfortunately, the patient died in the intensive care unit because of uncontrolled blood pressure and pneumonia.
CONCLUSIONS: This is a rare case of syphilis with testicular involvement and vasculitis. This report shows the importance of broadening the differential diagnoses of testicular firmness.
METHODS: A 63-year-old male presented with hard right eye swelling and very firm bilateral testes on palpation, which he had for 2 years. Testicular tumor markers were negative; syphilis test was positive. Radiological examination suggested aortitis and bilateral testicular malignancy. The patient received ampicillin for the infection and prednisolone for vasculitis. Left orchidectomy was performed to confirm the presence of testicular tumor; histological examinations revealed granulomatous orchitis. The prednisolone doses were adjusted because of relapses and adverse effects of steroid use. Unfortunately, the patient died in the intensive care unit because of uncontrolled blood pressure and pneumonia.
CONCLUSIONS: This is a rare case of syphilis with testicular involvement and vasculitis. This report shows the importance of broadening the differential diagnoses of testicular firmness.
摘要：
背景：我们报告了一例梅毒性睾丸胶质瘤和血管炎合并因长期使用类固醇引起的肾上腺衰竭的病例。
方法：一位63岁的男性，在触诊时表现为严重的右眼肿胀和非常坚固的双侧睾丸，他已经有两年了。睾丸肿瘤标志物阴性，梅毒试验阳性。放射学检查提示主动脉炎和双侧睾丸恶性肿瘤。患者接受氨苄西林治疗感染，泼尼松龙治疗血管炎。进行左睾丸切除术以确认睾丸肿瘤的存在；组织学检查显示肉芽肿性睾丸炎。由于使用类固醇的复发和不良反应，调整了泼尼松龙的剂量。不幸的是,患者因血压失控和肺炎在重症监护病房死亡。
结论：这是一例罕见的梅毒，伴有睾丸受累和血管炎。该报告显示了扩大睾丸硬度的鉴别诊断的重要性。
方法：一位63岁的男性，在触诊时表现为严重的右眼肿胀和非常坚固的双侧睾丸，他已经有两年了。睾丸肿瘤标志物阴性，梅毒试验阳性。放射学检查提示主动脉炎和双侧睾丸恶性肿瘤。患者接受氨苄西林治疗感染，泼尼松龙治疗血管炎。进行左睾丸切除术以确认睾丸肿瘤的存在；组织学检查显示肉芽肿性睾丸炎。由于使用类固醇的复发和不良反应，调整了泼尼松龙的剂量。不幸的是,患者因血压失控和肺炎在重症监护病房死亡。
结论：这是一例罕见的梅毒，伴有睾丸受累和血管炎。该报告显示了扩大睾丸硬度的鉴别诊断的重要性。
