title: Bilateral xanthogranulomatous orchitis in a tetraplegic patient.
abstract: Xanthogranulomatous orchitis (XGO) is a rare chronic inflammatory process characterized by destruction of tissue that is replaced by an outstanding cellular infiltrate of lipid-laden macrophages. To date, 20 cases of this process have been reported previously. We present herein the case of a 55-year-old man who had sustained complete tetraplegia at C-6 level and neuropathic bladder for 21 years. After repeated episodes of urinary tract infection, the patient developed a bilateral XGO and a right xanthogranulomatous epididymitis (XGE) that were treated with bilateral orchiepididymectomy. To our knowledge, a bilateral XGO has not yet been reported. Repeated episodes of high-pressure urinary reflux along the vas deferens during dyssynergic voiding possibly led to retrograde extension from the urinary tract by common urinary pathogens and development of bilateral XGO and right XGE. Since tissue destruction is a feature of this process, curative treatment required antibiotic therapy followed by bilateral excision of testes and epididymes.
authors.affiliation: Pathology Department, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria and IFIMAV, Santander, Spain. apavbj@humv.es
authors.forename: J Fernando
authors.initials: JF
authors.lastname: Val-Bernal
authors.forename: Liza
authors.initials: L
authors.lastname: Argueta
authors.forename: Alejandro
authors.initials: A
authors.lastname: Fernández-Flórez
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Correas
authors.forename: Daniel
authors.initials: D
authors.lastname: Val
authors.forename: M Francisca
authors.initials: MF
authors.lastname: Garijo
authors.forename: Gerardo
authors.initials: G
authors.lastname: López-Rasines
mesh_terms: D006099:Granuloma / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009920:Orchitis / Q000209:etiology / Q000473:pathology*; D011782:Quadriplegia / Q000150:complications*; D001750:Urinary Bladder, Neurogenic / Q000150:complications; D014973:Xanthomatosis / Q000209:etiology / Q000473:pathology*