Ruptured intra-abdominal testicular seminoma with hemorrhage shock, after inadequate surgical exploration for undescended testis: a case report.

Abstract

BACKGROUND:

Undescended testes are associated with an increased risk of malignancy and infertility, and surgical treatment in childhood is recommended.

CASE PRESENTATION:

A 35-year-old man presented to the emergency department with abdominal pain and vomiting. Despite a history of surgery for a left undescended testis in infancy, his left-sided scrotum appeared underdeveloped. Contrast-enhanced computed tomography showed a pelvic mass, involving a major axis of approximately 15 cm, with high-density ascites suggestive of hemorrhage. A ruptured gastrointestinal stromal tumor was suspected. As he was in hemorrhagic shock, an emergency laparotomy was indicated. The active bleeding mass was controlled through complete resection. A pathological evaluation of the mass revealed a seminoma arising from an undescended testis. His post-operative course was uneventful, and he was discharged on post-operative day 6. Recurrence on the retroperitoneal lymph nodes was detected 1 year postoperatively, and a retroperitoneal lymph node dissection was performed after chemotherapy. He remains well without any apparent signs of recurrence.

CONCLUSIONS:

Paying close attention to an empty scrotum is advisable, even postoperatively, for undescended testis because of possible subsequent potential malignancy presenting with hemorrhage, as our patient demonstrated.

• Authors: Hirotake Gonda, Takuya Saito, Takaaki Osawa, Shintaro Kurahashi, Tatsuki Matsumura, Yasuyuki Fukami, Shunichiro Komatsu, Kenitiro Kaneko, Kazuhiro Hiramatsu, Takehito Kato, Tsuyoshi Sano
• Journal: Surgical case reports (Surg Case Rep) Vol. 7 Issue 1 Pg. 65 (Mar 08 2021) ISSN: 2198-7793 [Print] Germany
• PMID: 33683491 (Publication Type: Journal Article)