A 26-year-old male patient complained of fever and night sweats in addition to severe right testicular swelling and pain for three days. Due to a small testicular tumor, he visited another hospital before coming to ours. They attempted a biopsy, which made things worse and caused huge testicular edema that grew larger and was hematous. He had anorexic and but his body weight loss was present. He had history of respiratory TB 11 years ago which was treated and he was smoker but non-alcoholic. In vital signs, temperature: 38 C, pulse: 111/mn, blood pressure: 135/81mmHg. Other systemics were unremarkable no other systemic involvement. Right testis were swelled tender firm and fixed to overlying skin. It gradually increased and there was no discharge or sinus. The laboratory tests: White Blood Cells 6.71 x 1000/mm3, Hemoglobin 11.1 g/dL, Platelet 298x1000/mm3, Neutrophil 4.55x1000/mm3, Lymphocyte 1.33x1000/mm3, C-Reactive Protein 22 mg/l, Aspartate transferase 18 U/L, Alanine Aminotransferase 9 U/L. Chest X-ray was normal. On scrotal ultrasound reveals an irregularly circumscribed mass lesion containing hypoechoic necrotic heterogeneous areas of approximately 20x15 mm was observed in the inferior right testis (TB?). There was a 81x63mm sized hypoechoic heterogeneous lesion in the right hemiscrotum. A collection containing hypoechoic and multiple pseudonodular heterogeneous areas measuring 9x7 cm in size was observed in the right hemiscrotum (Right scrotal hematoma?). An irregularly circumscribed mass lesion containing hypoechoic necrotic heterogeneous areas of approximately 27x17 mm in the right testis inferior without vascularity was observed (Granulomatous TB? Mass?). FNAB was recommended. So we diagnosed caseating granulomatous inflammation and histopathological findings were compatible with TB (Figures 3 and 4). We made testicular exploration and hematoma was evacuated from the sac, and after operation we started anti-TB treatment regimen consisting of rifampicin, isoniazid, pyrazinamide, and ethambutol for the first two months, followed by rifampicin and isoniazid for the following four months, was administered.  
Under treatment, patients' complaints such as fever and night sweats disappeared. Control testicular ultrasound showed a decrease in nodule size. Treatment was completed for six months and stopped.