Retroperitoneal extension of massive ulcerated testicular seminoma through the inguinal canal: A case report

  • Alessio Antonaci Department of Medical, Oral and Biotechnological Sciences, G. d'Annunzio University of Chieti, Urology Unit, SS. Annunziata Hospital, Chieti, Italy.
  • Daniela Fasanella | danielafasanella20@gmail.com Department of Medical, Oral and Biotechnological Sciences, G. d'Annunzio University of Chieti, Urology Unit, SS. Annunziata Hospital, Chieti, Italy.
  • Vikiela Galica Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila “San Salvatore” Hospital, L’Aquila, Italy.
  • Nicola Tinari Department of Medical, Oral and Biotechnological Sciences and Center for Advance Studies and Technology (CAST), G. D'Annunzio University of Chieti, Italy.
  • Jamara Giampietro Clinical Oncology Unit, SS Annunziata Hospital, Chieti, Italy.
  • Pietro Di Marino Clinical Oncology Unit, SS Annunziata Hospital, Chieti, Italy.
  • Andrea Delli Pizzi Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University of Chieti, Chieti, Italy.
  • Raffaella Basilico Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University of Chieti, Chieti, Italy.
  • Luigi Schips Department of Medical, Oral and Biotechnological Sciences, G. d'Annunzio University of Chieti, Urology Unit, SS. Annunziata Hospital, Chieti, Italy.
  • Michele Marchioni Department of Medical, Oral and Biotechnological Sciences, G. d'Annunzio University of Chieti, Urology Unit, SS. Annunziata Hospital, Chieti, Italy.

Abstract

Introduction: Testicular cancers represent about 5% of all urological malignancies and 1-1.5% of all male neoplasms. Most of the testicular cancers are localized (68%) at diagnosis. Bulky masses in the scrotum are rare. We present a rare case of bulky testicular cancer with retroperitoneal spread through the inguinal canal.
Case report: A 44-year-old man came to the emergency department referring weakness and the presence of a scrotal mass. At physical examination, a voluminous mass was found, with necrotic phenomena within the scrotum. Abdomen was tense and sore. Abdominal CT scan revealed a bulky testicular mass spreading to the retroperitoneal space through the inguinal canal with node enlargement. Patient underwent orchiectomy with excision of infiltrated scrotum skin. Histologic diagnosis confirmed a typical form seminoma. The patient was then treated with a cisplatin-based chemotherapy, with a partial response. The patient recently relapsed and he is being treated with a new line of chemotherapy and subsequent surgery with or without radiotherapy.
Conclusions: We described a rare presentation of testicular cancer. This case highlights the importance of a multidisciplinary approach to rare testis tumour presentation and early diagnosis for testicular cancers.

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References

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Published
2021-03-19
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Section
Case Reports
Keywords:
Testicular cancer, Large seminoma, Retroperitoneal space, Inguinal lymph nodes
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How to Cite
Antonaci, A., Fasanella, D., Galica, V., Tinari, N., Giampietro, J., Di Marino, P., Delli Pizzi, A., Basilico, R., Schips, L., & Marchioni, M. (2021). Retroperitoneal extension of massive ulcerated testicular seminoma through the inguinal canal: A case report. Archivio Italiano Di Urologia E Andrologia, 93(1), 64-67. https://doi.org/10.4081/aiua.2021.1.64