Briquet syndrome in a man with chronic intractable pain

A 51-year-old man was admitted for evaluation and treatment of scrotal pain of 20 years' duration following unilateral orchiectomy for right testicular injury. Past attempts had failed to provide definitive or persistent relief. Physical examination and investigations were unremarkable. Psychiatric assessment revealed an angry, depressed man with a dramatic, hypermasculine manner and hysterical and obsessive personality traits. Review of systems with a structured interview indicated that the patient had numerous medically unexplained symptoms and that he fulfilled both the Feighner and the Diagnostic and Statistical Manual of Mental Disorders 3rd edition (DSM-III) diagnostic criteria for Briquet syndrome. The case is important because it demonstrates the usefulness of recognizing Briquet syndrome in patients with the single presenting complaint of chronic, intractable pain, and the fact that Briquet syndrome, commonly considered a female disorder, can occur in men regardless of sexual orientation and in the absence of expected compensation. In addition, the case confirms the utility of a structured interview and defined criteria for making the diagnosis of Briquet syndrome.