Abstract
BackgroundUndescended testes are associated with an increased risk of malignancy and infertility, and surgical treatment in childhood is recommended.Case presentationA 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.ConclusionsPaying 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.
Highlights
BackgroundUndescended testes are a common birth anomaly [1]. Approximately 10% of undescended testes are located in the abdominal cavity, and an intra-abdominal testis has been reported to be at a higher risk of testicular cancer than an inguinal testis [2, 3]
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
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
Summary
Undescended testes are a common birth anomaly [1]. Approximately 10% of undescended testes are located in the abdominal cavity, and an intra-abdominal testis has been reported to be at a higher risk of testicular cancer than an inguinal testis [2, 3]. Case presentation A 35-year-old married father of a newborn infant was transferred to the emergency department complaining of abdominal pain and an approximate 10-h history of vomiting Gonda et al surg case rep (2021) 7:65 of left undescended testis in infancy He and his parents had noticed that his left scrotum was still small after the surgery, but they had not paid attention to it and had not seen a doctor. His blood pressure was 80/55 mmHg, his pulse rate was 130 beats/min, and he was in shock On clinical examination, he presented with abdominal distention and diffuse tenderness with guarding. We diagnosed hemorrhagic shock due to rupture of the pelvic mass, which was suspected to be a gastrointestinal stromal tumor He was infused with 2500 ml of extracellular fluid preoperatively. One year after the radical retroperitoneal lymph node dissection, he remains well without any signs or symptoms of tumor recurrence
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