A rare case of tuberculous epidydimo-orchitis mimicking hydrocele: A diagnostic dilemma

A rare occurrence, isolated tubercular epididymo-orchitis poses a diagnostic and therapeutic challenge. A 45-year old male presented with a right scrotal swelling since 5 months which, based on physical examination and ultrasonographic findings, was suggestive of a right hydrocele. Operative findings during the transvaginal hydrocele repair revealed dense adhesions with granulomatous necrosis and therefore, prompted us to perform a right-sided orchidectomy. Histopathological study thereafter revealed features of tuberculous epididymo-orchitis. Hence, it is imperative to consider a differential diagnosis of tuberculous epididymo-orchitis in a case of scrotal swelling in a country like India where tuberculosis is known to be endemic.