Abstract
Germ cell tumors presenting with an acute abdomen are not common. We present a case of seminoma with ileum perforation, which presented in a 48-year-old man. who had been admitted to hospital with a right lower abdominal palpable mass measuring approximately 16 cm. Before an exploratory laparotomy was performed, acute abdomen with signs of hollow viscus perforation had occurred. An ileum perforation was detected and a right hemicolectomy and ileal resection were performed. The pathological examination showed a classic seminoma of undescended testis. In conclusion, this case is interesting with respect to its clinical picture of acute abdomen due to ileal perforation. The possibility of a germ cell tumor should always be kept in mind in male patients with acute abdomen.
[1] Tanaka T, Kitamura H, Kunishima Y, Takahashi S, Takahashi A, Masumori N, Itoh N, Tsukamoto T. Modified and bilateral retroperitoneal lymph node dissection for testicular cancer: peri- and postoperative complications and therapeutic outcome. Jpn J Clin Oncol. 2006:36:381–386 http://dx.doi.org/10.1093/jjco/hyl02610.1093/jjco/hyl026Search in Google Scholar
[2] Sexton WJ, Wood CG, Kim R, Pisters LL. Repeat retroperitoneal lymph node dissection for metastatic testis cancer. J Urol. 2003:169:1353–1356 http://dx.doi.org/10.1097/01.ju.0000052372.06901.de10.1097/01.ju.0000052372.06901.deSearch in Google Scholar
[3] Spiess PE, Kassouf W, Brown GA, Kamat AM, Liu P, Gomez JA. et al. Surgical management of growing teratoma syndrome: the M. D. Anderson cancer center experience. J Urol. 2007:177:1330–1334 http://dx.doi.org/10.1016/j.juro.2006.11.08610.1016/j.juro.2006.11.086Search in Google Scholar
[4] Bauernhofer T, Eibl M, Ploner F, Kuss I, Pfeifer J, Sill H, Samonigg H. Acute pseudo-obstruction of the small intestine following high-dose chemotherapy and stem cell support. Onkologie. 2003:26:344–346 http://dx.doi.org/10.1159/00007209310.1159/000072093Search in Google Scholar
[5] Lim YJ, Jeong MJ, Bae BN, Kim SH, Kim JY. Seminoma in undescended testis. Abdom Imaging. 2008:33:241–243 http://dx.doi.org/10.1007/s00261-007-9219-z10.1007/s00261-007-9219-zSearch in Google Scholar
[6] Elert A, Jahn K, Heidenreich A, Hofmann R. The familial undescended testis. Klin Padiatr. 2003:215:40–45 http://dx.doi.org/10.1055/s-2003-3689410.1055/s-2003-36894Search in Google Scholar
[7] Toppari J, Kaleva M. Maldescendus testis. Horm Res. 1999:51:261–269 http://dx.doi.org/10.1159/00002341210.1159/000023412Search in Google Scholar
[8] Hutson JM, Donahoe PK. The hormonal control of testicular descent. Endocr Rev. 1986:7:270–283 http://dx.doi.org/10.1210/edrv-7-3-27010.1210/edrv-7-3-270Search in Google Scholar
[9] Yamanaka J, Baker M, Metcalfe S, Hutson JM. Serum levels of Mullerian inhibiting substance in boys with cryptorchidism. J Pediatr Surg. 1991:26:621–623 http://dx.doi.org/10.1016/0022-3468(91)90723-710.1016/0022-3468(91)90723-7Search in Google Scholar
[10] Hutson JM, Watts LM. Both gonadotropin and testosterone fail to reverse estrogen-induced cryptorchidism in fetal mice: Further evidence for nonandrogenic control of testicular descent in the fetus. Pediatr Surg Int. 1990:5:13–18 http://dx.doi.org/10.1007/BF0017963110.1007/BF00179631Search in Google Scholar
[11] Wensing CJ. The embryology of testicular descent. Horm Res. 1988:30:144–152 http://dx.doi.org/10.1159/00018105110.1159/000181051Search in Google Scholar
[12] Backhouse KM. The natural history of testicular descent and maldescent. Proc R Soc Med. 1966:59:357–360 10.1177/003591576605900417Search in Google Scholar
[13] Hutson JM., Beasley SW. The mechanisms of testicular descent. Aust Paediatr J. 1987, 23, 215–216 10.1111/j.1440-1754.1987.tb00252.xSearch in Google Scholar
[14] Levard G, Laberge JM. The fate of undescended testes in patients with gastroschisis. Eur J Pediatr Surg. 1997:7:163–165 http://dx.doi.org/10.1055/s-2008-107108110.1055/s-2008-1071081Search in Google Scholar
[15] Batata MA, Whitmore JR WF, Chu FCH, Hilaris BJ, Loh J, Grabstald H, et al. Cryptorchidism and testicular cancer. J Urol. 1980:124:382–387 10.1016/S0022-5347(17)55458-0Search in Google Scholar
[16] Kulkarni JN, Kamat MR. Tumors in undescended testis. J Surg Oncol. 1991:46:257–260 http://dx.doi.org/10.1002/jso.293046040910.1002/jso.2930460409Search in Google Scholar
[17] Villavicencio H, Martinez E, Vicente-Carretero R. Simultaneous bilateral testicular tumors. Actas Urol Esp. 1989:13:403–404 Search in Google Scholar
[18] Martin DC. Malignancy in the cryptorchid testis. Clin North Am. 1982:9:37 10.1016/S0094-0143(21)01351-3Search in Google Scholar
[19] Rogers E, Teahan S, Gallagher H, Butler MR, Gringer R, McDermott TE, et al. The role of ochiectomy in the management of postpuberal cryptorchidism. J Urol. 1998:159:851–854 http://dx.doi.org/10.1016/S0022-5347(01)63752-210.1016/S0022-5347(01)63752-2Search in Google Scholar
[20] Hamle A, Kellokumpu-Lehtinen P, Lehtonen T, Teppo L. Morphology of testicular germ cell tumours in treated and untreated cryptorchidism. Br J Urol. 1989:64:78–83 http://dx.doi.org/10.1111/j.1464-410X.1989.tb05527.x10.1111/j.1464-410X.1989.tb05527.xSearch in Google Scholar PubMed
[21] Miocinovic R, Abaza R. Testicular seminoma presenting with duodenal perforation: a case report. J Med Case Reports. 2008:2:294 http://dx.doi.org/10.1186/1752-1947-2-29410.1186/1752-1947-2-294Search in Google Scholar PubMed PubMed Central
[22] Johnson DE, Appelt G, Samuels ML, Luna M. Metastases from testicular carcinoma. Study of 78 autopsied cases. Urology. 1976:8:234–239 http://dx.doi.org/10.1016/0090-4295(76)90374-510.1016/0090-4295(76)90374-5Search in Google Scholar
[23] Chait MM, Kurtz RC, Hajdu SI. Gastrointestinal tract metastases in patients with germ cell tumor of the testis. Am J Dig Dis. 1978:23:925–928 http://dx.doi.org/10.1007/BF0107246810.1007/BF01072468Search in Google Scholar
[24] De Castro CA, Dockerty MB, Mayo CW. Metastatic tumors of the small intestines. Surg Gynecol Obstet. 1957:105:159–165 Search in Google Scholar
[25] Watkins GL. Massive hemoperitoneum resulting from rupture of a seminoma in an undescended testicle. J Urol. 1970:103:447–448 10.1016/S0022-5347(17)61978-5Search in Google Scholar
[26] Hutcheson JC, Khorasani R, Capelouto CC, Moore FD Jr, Silverman SG, Loughlin KR. Torsion of intraabdominal testicular tumors. A case report. Cancer. 1996:77:339–343 http://dx.doi.org/10.1002/(SICI)1097-0142(19960115)77:2<339::AID-CNCR17>3.0.CO;2-210.1002/(SICI)1097-0142(19960115)77:2<339::AID-CNCR17>3.0.CO;2-2Search in Google Scholar
[27] Miocinovic R, Abaza R. Testicular seminoma presenting with duodenal perforation: a case report. J Med Case Reports. 2008:2:294 http://dx.doi.org/10.1186/1752-1947-2-29410.1186/1752-1947-2-294Search in Google Scholar
[28] Elder JS. Ultrasonography is unnecessary in evaluating boys with a nonpalpable testis. Pediatrics. 2002:110:748–751 http://dx.doi.org/10.1542/peds.110.4.74810.1542/peds.110.4.748Search in Google Scholar
[29] Bree RL, Hoang DT. Scrotal ultrasound. Radiol Clin North Am. 1996:6:1183–1205 10.1016/S0033-8389(22)00697-2Search in Google Scholar
[30] Jordan GH. Laparoscopic management of the undescended testicle. Urol Clin North Am. 2001:28:23–29 http://dx.doi.org/10.1016/S0094-0143(01)80004-510.1016/S0094-0143(01)80004-5Search in Google Scholar
[31] Ahmad SS, Akhtar K, Akhtar SS, Nasir A, Khalid M, Mansoor T. Ultrasound guided fine needle aspiration biopsy of retroperitoneal masses. J Cytology. 2007:24:41–45 http://dx.doi.org/10.4103/0970-9371.4209010.4103/0970-9371.42090Search in Google Scholar
© 2010 Versita Warsaw
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
