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Sarcoïdose épididymaire

Epididymal sarcoidosis

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Les auteurs soulignent le polymorphisme clinique de la sarcoïdose et rapportent un cas de localisation épididymaire. Du point de vue étiopathogénique plusieurs hypothèses sont avancées (mycobactéries, facteurs immunologiques, facterus génétiques, virus). La race noire apparaît plus touchée que la race blanche.

Le traitement chirurgical repose sur la chirurgie d'exérèse que nous avons réalisée sur le nodule épididymaire. Pour le traitement médical nous avons opté pour la chloroquine à la dose de 300 mg/j. Après 4 ans d'évolution l'état du patient est stabilisé.

Abstract

The Sarcoidosis or Besnier Boeck Schaumann's disease is a systemic granulomatous disorders. Multiple organs but specially lungs and skin may be affected. We describe an uncommon case of genital localisation in one patient with epididymal sarcoidosis, regarding on the heterogeneous clinic presentations of this affection.

References show differents hypotesis about the pathogenesis: mycobacterial, viruses, imunologic or genetic factors. There are also a race predominance in black population.

The patient was referred to us for testicular pain associated with a palpable epididymal node, subcutaneous thoracic and limbs, painless nodes, and rhinorrea. With the first clinic approach we attempted the diagnosis of epididymal tuberculosis, which was corrected after to sarcoidosis with the conjunction of several items on a score disease basis. The biopsy confirmed the diagnosis of sarcoidosis, so we began the medical treatment including chloroquine: 300 mg/day during 3 years (to avoid recurrences). As the usual surgical treatment, we submitted our patient to an epididymal node resection. After a 4 years follow-up, there are no evidences of disease.

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Ba, M., Syllac, Gueyes, M. et al. Sarcoïdose épididymaire. Androl. 5, 544–547 (1995). https://doi.org/10.1007/BF03034540

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