Testicular schistosomiasis: a clinico-pathological presentation of three pediatric cases and review of literature

Schistosomiasis is an important communicable disease in developing countries and an important cause of morbidity in the tropics and subtropics. It is a very rare cause of painless testicular swelling that tend to mimic malignancy and cause a diagnostic dilemma. Though histopathologic analysis confirms diagnosis, a high index of suspicion is required especially for patients presenting from endemic areas. We aim to present the clinicopathological features of three pediatric cases of Testicular Schistosomiasis (TS) and to highlight the role of high index of suspicion, incisional biopsy and histopathologic diagnosis in prevention of unwarranted orchiectomy and preservation of testicular function. We report three cases of TS in patients aged 5 years, 12 years and 14 years, who presented with progressive testicular swellings. The diagnoses were made by histopathological analysis and the patients were treated with oral praziquantel. TS should always be considered an important differential in all male children and adults presenting with testicular masses especially when they live in endemic regions. Incisional biopsy, proper histopathologic evaluation and treatment could prevent unwarranted orchiectomy and thus preserve testicular function.