Bilharzia or schistosomiasis is a parasitic disease due to infestation by a hematophagous trematode of the genus
Schistosoma. It is the second most frequent parasitic endemic in the world after malaria. The most frequent tissue
infections are intestinal and genitourinary. Testicular localizations of schistosoma are very rare. When lesions
become chronic, they present as non-specific masses, bilharziomas, posing enormous problems of differential
diagnosis with other benign and malignant pathologies, which impacts management. We report a case of
epididymal schistosomiasis in a 37 years old patient simulating a malignant tumor. This case allowed us to review
the diagnostic difficulties of this rare localization and the challenges of management.

Schistosomiasis, Testis, Pseudotumor, Pathological Anatomy