Sperm granuloma of the epididymis mimicking a neoplasm; a case report

İntroduction:

Sperm granuloma is an exuberant foreign body reaction to extravasated sperm which is thought to result from damage of epididymal duct epithelium and basement membrane because of trauma or inflammation.

Case report:

A 53 year old man?s magnetic resonance revealed an irregular heterogenous mass with a size of 21x17x17 mm in the right epididymis.

Histopathology of the epididymectomy which was suspicious for malignancy showed a granulomatous with an acute inflammatory response consisting of histiocytes and mixed inflammatory cells. Because of chronic inflammation with fibrosis this lesion was clinically mimicking a neoplasm.

Conclusion:

Sperm granulomas can range in size between 1-4 cm, well-defined, solid, hypoechoic masses and are generally asymptomatic.Foreign body granulomas, necrosis and fibrosis may be present around excavasated sperms on histopathology.

We present this rare case which mimicks a tumor. Urologists and pathologists must keep in mind this rare entity for the epididymal masses.