Retroperitoneal extension of massive ulcerated testicular seminoma through the inguinal canal: A case report
https://doi.org/10.4081/aiua.2021.1.64
Accepted: June 26, 2020
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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.
Chia VM, Quraishi SM, Devesa SS, et al. International trends in the incidence of testicular cancer, 1973-2002. Cancer Epidemiol Biomark Prev. 2010; 19:1151-9. DOI: https://doi.org/10.1158/1055-9965.EPI-10-0031
Huyghe E, Matsuda T, Thonneau P. Increasing incidence of testicular cancer worldwide: a review. J Urol. 2003; 170:5-11. DOI: https://doi.org/10.1097/01.ju.0000053866.68623.da
Shanmugalingam T, Soultati A, Chowdhury S, et al. Global incidence and outcome of testicular cancer. Clin Epidemiol. 2013;5:417-27.
Moch H, Cubilla AL, Humphrey PA, et al. The 2016 WHO classification of tumours of the urinary system and male genital organs-Part A: Renal, penile, and testicular tumours. Eur Urol. 2016; 70:93-105. DOI: https://doi.org/10.1016/j.eururo.2016.02.029
Palumbo C, Mistretta FA, Mazzone E, et al. Contemporary incidence and mortality rates in patients with testicular germ cell tumors. Clin Genitourin Cancer. 2019; 17:e1026-35. DOI: https://doi.org/10.1016/j.clgc.2019.06.003
Saxman SB, Finch D, Gonin R, Einhorn LH. Long-term follow-up of a phase III study of three versus four cycles of bleomycin, etoposide, and cisplatin in favorable-prognosis germ-cell tumors: the Indian University experience. J Clin Oncol. 1998; 16:702-6. DOI: https://doi.org/10.1200/JCO.1998.16.2.702
Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 1990. 2009; 45:228-47.
Mihor A, Tomsic S, Zagar T, et al. Socioeconomic Inequalities in Cancer Incidence in Europe: A Comprehensive Review of Populationbased Epidemiological Studies. Radiol Oncol. 2020; 54:1-13. DOI: https://doi.org/10.2478/raon-2020-0008
Marchioni M, Martel T, Bandini M, et al. Marital status and gender affect stage, tumor grade, treatment type and cancer specific mortality in T1-2 N0 M0 renal cell carcinoma. World J Urol. 2017;35:1899-905. DOI: https://doi.org/10.1007/s00345-017-2082-9
Macleod LC, Cannon SS, Ko O, Schade GR, et al. Disparities in Access and Regionalization of Care in Testicular Cancer. Clin Genitourin Cancer. 2018; 16:e785-93. DOI: https://doi.org/10.1016/j.clgc.2018.02.014
Honecker F, Aparicio J, Berney D, et al. ESMO Consensus Conference on testicular germ cell cancer: diagnosis, treatment and follow-up. Ann Oncol. 2018; 29:1658-86. DOI: https://doi.org/10.1093/annonc/mdy217
Warde P, Specht L, Horwich A, et al. Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis. J Clin Oncol 2002;20:4448-52. DOI: https://doi.org/10.1200/JCO.2002.01.038
Aparicio J, Germà JR, García del Muro X, et al. Risk-adapted management for patients with clinical stage I seminoma: the Second Spanish Germ Cell Cancer Cooperative Group study. J Clin Oncol. 2005; 23:8717-23. DOI: https://doi.org/10.1200/JCO.2005.01.9810
Park S, Lee S, Lee J, et al. Salvage chemotherapy with paclitaxel, ifosfamide, and cisplatin (TIP) in relapsed orcisplatin-refractory germ cell tumors. Onkologie. 2011; 34:416-20. DOI: https://doi.org/10.1159/000331129
Oldenburg J, Fosså SD, Nuver J, et al. Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol Off J Eur Soc Med Oncol. 2013;24 Suppl 6:vi125-132. DOI: https://doi.org/10.1093/annonc/mdt304
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
