Treatment of
testicular cancer is dependent on the stage of disease at presentation. Stage 1
testicular cancer is treated with radical
orchiectomy, followed by active surveillance,
radiotherapy, or
chemotherapy. Occasionally, unusual and unexpected postoperative changes can be seen on computed tomography (CT), and may raise concern for metastatic disease. Here, we present two cases of
testicular cancer patients who developed retroperitoneal
hematomas post-radical
orchiectomy, one as a classical clinical presentation, and the other as an atypical radiological entity only. The first is a case of a 38-year-old male with a non-
seminoma testicular cancer, who developed severe
flank pain, hemodynamic instability, and progressive
anemia from a retroperitoneal
hematoma in the immediate (<24 hours) postoperative period, requiring urgent surgical evacuation. The second is a case of a 33-year-old male with a testicular
seminoma who had a large, suspicious retroperitoneal mass on a staging CT scan concerning for metastatic disease, which was later diagnosed as a retroperitoneal
hematoma. These cases reveal the clinical variability with which a retroperitoneal
hematoma post-radical
orchiectomy may present. In addition, the second case demonstrates the importance of recognizing radiological postoperative changes and ensuring that these findings are not mistaken for and treated as metastatic disease.