Testicular sarcoidosis

Last revised by Jeremy Jones on 20 Sep 2021

Testicular sarcoidosis is a rare manifestation of sarcoidosis. In cases of urogenital sarcoidosis, more commonly the epididymis is affected.

Testicular sarcoidosis is more common in African-American patients, as are other forms of sarcoidosis 1. Up to 5% of patients with chronic sarcoidosis have evidence of testicular disease on autopsy 2.

Patients may be asymptomatic or present with pain or a mass 2.

Testicular sarcoidosis should be considered in cases where there are multiple masses in the testis and epididymis 3

On ultrasound, enlarged epididymides and multiple nodules with decreased echogenicity can be expected 2

Expected findings on MRI include 2:

  • T1 C+ (Gd)
    • enlarged epididymides
    • may be unilateral and solitary, however, more often are multiple, small, bilateral nodular lesions 
    • enhancing with contrast
  • T2: as above however lesions show low signal intensity

Excluding a testicular malignancy and preserving fertility are the main goals of treatment 1.

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