We present the case of a 76-year-old patient, with no known allergies, with a history of dyslipidaemia, arterial hypertension, old acute myocardial infarction, triple aorto-coronary bypass for 3-vessel disease, one year old, and TUR for leiomyoadenomatous hyperplasia of the prostate, two years old. No previous testicular trauma was reported. He also had no clinical, radiological or laboratory history of tuberculosis or brucellosis. He consulted the urology department for testicular discomfort, consisting of intermittent chronic mild pain, of 4 months' evolution, with a hard and irregular nodule on examination in the right testicle with no accompanying spontaneous pain or pain on palpation.
Ultrasound findings revealed a low echogenicity, lobulated, nodular focal lesion 2 cm in diameter in the lower pole of the right testicle, vascularised, and therefore compatible with neoformation. The left testicle had no pathological findings of interest.

Abdominal and pelvic CT scan with contrast shows no evidence of retroperitoneal lymphadenopathy.
Blood tests showed normal values for alpha-fetoprotein, HCG and LDH (HCG: 1.74 U/l; alpha-fetoprotein: 2.07 ng/ml; LDH: 299 mU/ml).
The patient underwent a right inguinal orchiectomy.
The macroscopic anatomopathological study showed a scrotal pouch with hydrocele measuring 8 x 5 x 2.5 cm with 5 cm of epididymal duct. The section showed a testicle measuring 5.5 x 2.5 x 2.5 x 2.5 cm, of fibrous consistency, with no macroscopic lesions compatible with neoplasia. Microscopic examination showed testicular parenchyma with vacuolated degeneration of germ cells and Sertoli cells, with vesicular nuclei, and a mononuclear inflammatory infiltrate with lymphocytes and plasma cells on the walls of the seminiferous tubules. There are numerous granulomatous formations with abundant multinucleated giant cells located in the stroma between the seminiferous tubules and some of them inside the seminiferous tubules. No neoplastic cellularity was observed. PAS and Ziehl Nielsen staining showed no mycotic microorganisms or mycobacteria. Histopathological findings suggest the diagnosis of idiopathic granulomatous orchitis.