Hemoperitoneo como manifestación inicial de tumor testicular

Abstract

IntroductionTesticular cancer has a frequency of between 1-1.5% of all male tumours. It is the most common solid tumour in males between 15 and 34 years old, and it has a high overall survival with correct treatment and follow-up. For this reason it has a low mortality rate in young adults. The case is reported of an uncommon presentation of testicular cancer. Materials and methodsThe case is presented of a 28 year-old male patient, evaluated for abdominal pain and referred with a diagnosis of acute abdomen due to appendicitis. A massive haemoperitoneum from a bleeding liver metastasis was found during surgery. Extension studies documented retroperitoneal mass and left testicular mass. Testicular tumour was diagnosed and appropriate treatment was performed. ResultsThe patient was treated by a multidisciplinary group that included oncological urology, radiology, surgery, and clinical oncology. He had a satisfactory post-operative outcome, and received chemotherapy with good clinical progress. ConclusionsThe initial presentation as haemoperitoneum is uncommon in patients with testicular tumour, but should be suspected in spontaneous abdominal and retroperitoneal bleeding. A timely diagnosis and intervention are critical to improve survival in these patients.