Auwal Idris Kabuga, Rufai Yunusa, Ahmad Hamza, Nura Yusuf, Musbahu Yusuf, Muhammad Yaseen Hassan
Schistosomiasis is a neglected tropical disease, with the highest burden in Sub-Saharan Africa, predominantly due to Schistosoma haematobium. Testicular involvement is rare; fewer than 30 cases have been reported in the literature to date, though sporadic reports continue to emerge from endemic areas. We report the case of a 34-year-old school teacher from Kano, Nigeria, with a history of freshwater exposure and childhood schistosomiasis treated with praziquantel. He presented with a two-year history of a firm, progressively enlarging left hemi-scrotal mass. Clinical examination and scrotal ultrasound were both suggestive of a testicular tumour. The patient underwent left radical orchidectomy. Histopathological examination, independently verified by three pathologists, revealed calcified Schistosoma ova within a densely fibrotic, granulomatous background, with no evidence of malignancy. This case underscores testicular schistosomiasis as an important differential diagnosis for testicular masses in endemic regions, and highlights the central role of histopathology in preventing unnecessary orchidectomy.