Case Report
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World J Clin Cases. Oct 16, 2022; 10(29): 10787-10793
Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10787
Bilateral occurrence of sperm granulomas in the left spermatic cord and on the right epididymis: A case report
Ding-Yang Lv, Hong-Jie Xie, Fan Cui, Hui-Yu Zhou, Wei-Bing Shuang
Ding-Yang Lv, Hong-Jie Xie, Fan Cui, Hui-Yu Zhou, Wei-Bing Shuang, Department of Urology, The First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Author contributions: Lv DY contributed to the manuscript writing, editing and data collection; Xie HJ contributed to the data collation; Cui F conducted the literature review; Zhou HY and Shuang WB revised the manuscript; All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wei-Bing Shuang, MD, PhD, Chief Doctor, Doctor, Department of Urology, The First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Yingze District, Taiyuan 030001, Shanxi Province, China.
Received: June 28, 2022
Peer-review started: June 28, 2022
First decision: July 14, 2022
Revised: July 22, 2022
Accepted: September 8, 2022
Article in press: September 8, 2022
Published online: October 16, 2022

Sperm granuloma is a rare disease in clinical andrology and its incidence is still unclear worldwide. According to the existing literature, sperm granuloma often occurs unilaterally. Clinical and ultrasound features are similar to epididymal tuberculosis, chronic epididymitis and other diseases. Sperm granuloma is usually diagnosed based on postoperative histopathological and immunohistochemical examination.


A 46-year-old man was admitted to the hospital due to the presence of a left scrotal mass for 3 mo and aggravation of pain for 1 wk. The lesions at both sites were surgically resected. Postoperative pathological examination showed that the left spermatic cord mass and the right epididymal mass were consistent with sperm granuloma. The sperm granulomas then recurred 3 mo after surgery. There is little change in the local mass so far.


The case report is helpful for our understanding of this disease. In clinical diagnosis, it should be distinguished from epididymal tuberculosis, chronic epididymitis and other diseases. Color Doppler ultrasound can be used as a preferred examination method but postoperative pathological examination is still needed for diagnosis.

Keywords: Sperm granuloma, Epididymis, Spermatic cord, Recurrence, Case report

Core Tip: We reported on a rare case of sperm granuloma which occurred bilaterally in the left spermatic cord and on the right epididymis. Remarkably, the granuloma recurred at 3 mo after surgery and this recurrence has not been reported before. Since the patient has no history of vasectomy, tumor or trauma, it is more likely that this case of sperm granuloma is merely caused by inflammation which is rare for sperm granuloma. This case report can greatly enhance our understanding of sperm granuloma and it is helpful for differential diagnosis of various epididymal lesions in clinical practice.