Primary retroperitoneal seminoma: an unusual cause of testicular pain

Abstract

Germ cell tumours in men usually arise from the testes, with only 1–2% originating from other locations.1 These so-called primary extra-gonadal germ cell tumours (EGCTs) are rare, accounting for 0.15–0.2% of all malignancies.2 They are characterized by their midline location, and have been reported to occur anywhere from the pineal gland to the coccyx, with the commonest locations being the mediastinum and the retroperitoneum.3 Lack of awareness of this condition, together with its rarity, often results in diagnostic delay. The commonest presenting symptoms of retroperitoneal germ cell tumours (GCTs) are abdominal and back pain, but can include weight loss, night sweats, venous thrombosis and scrotal oedema among others.3 However, there have been no reported cases of testicular pain as a presenting complaint. Here we report such a case, and highlight the difficulties in diagnosis.