Large intra-abdominal seminoma in a left undescended testicle complicated by torsion

Abstract

A 39-year-old man presented with a 2-day history of worsening constant, dull diffuse lower abdominal pain with associated constipation and known history of left undescended testicle. He was evaluated at an outside hospital where a non-contrasted CT scan revealed a 20 cm well-circumscribed soft tissue mass within the pelvis.He was referred and further imaging revealed a 12 cm heterogeneous mass with foci of air that appeared to be contiguous with the left spermatic cord. This constellation of findings could represent torsion of undescended left testicle with infarction or underlying malignancy. Tumour markers were only significant for elevated lactate dehydrogenase of 1445. A subsequent ultrasound-guided biopsy of the mass demonstrated seminoma.Surgical resection revealed a large intra-abdominal mass emanating from the left spermatic cord with 270° of torsion. There appeared to be a left atrophic remnant testicle at the base of the mass with final pathology confirming the diagnosis of classic seminoma.

Unusual presentation of an intra-abdominal testicular seminoma in an adult

“… 2 In some cases, patients can present with acute complications such as torsion or hemorrhage. 4 Our patient however presented with isolated left flank pain, probably due to hydronephrosis, which is an unusual symptom in this context. Retroperitoneal lymph node metastasis can typically be responsible for hydronephrosis either by ureteric invasion or compression.…”

Colic signs caused by an unilateral abdominal seminoma in a Friesian stallion

“…The torsion of the spermatic cord as well as the weight of the mass itself could have been responsible for the colic signs. Abdominal testicular neoplasms are known to occasionally be associated with testicular torsion, which often is characterised by abdominal pain (Brown et al., 1995; Edwards, 2008; Mostachio et al., 2007; Nelson & Calley, 1987; Rourke et al., 2018; Uguz et al., 2016).…”

Is Testicular Torsion a Real Problem in Pediatric Patients With Cryptorchidism?

“…Usually, the most common symptom is abdominal pain. In the literature, the reports of cases of testicular torsion of the intra-abdominal seminoma can be found ( 39 , 40 ).…”