Paragonimiasis (lung fluke) can involve extrapulmonary sites. Rarely it can present as a testicular mass. The diagnosis is rarely made prior to surgery.
Clinical features:
(1) history of eating uncooked river crabs or other source
(2) one or more nodules in the scrotum that are tender to palpation
The diagnosis usually is based on the pathologic exam of the resected nodule.
Issues in patient management:
(1) Radical orchiectomy should not be performed without cause. Careful imaging studies may reduce the risk of excessive surgery.
(2) The patient should be examined for foci of paragonimiasis in the lungs and elsewhere.
(3) Praziquantel therapy should be given after the diagnosis is made.
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