Intrascrotal involvement of sarcoidosis presenting like testicular appendices

A 31-year-old male visited our clinic with a complaint of painless intrascrotal mass in the left side. He had been diagnosed with pulmonary sarcoidosis 6 years prior. Scrotal ultrasound revealed a distinct mass measuring 18 mm x 16 mm at the left epididymal tail. An epididymectomy was performed for treatment and pathological diagnosis. Four nodules shaped like testicular appendices were also found on the testicular surface and subsequently removed. Histopathological examination established that both the epididymal and appendix-like lesions consisted of non-caseating epithelioid granulomas with giant cells, and were diagnosed as sarcoidosis. The patient has no recurrence of intrascrotal lesions after 6-month follow up. This is the first report of intrascrotal involvement of sarcoidosis presenting like testicular appendices.