Sriselvakumar Sajanakan, Meehan Louise
Emergency Department, Mater Public Hospital, Raymond Terrace, South Brisbane, Australia.
Radiologist at Queensland Xray, Mater Public Hospital, Raymond Terrace, South Brisbane, Australia.
Radiol Case Rep. 2024 Apr 13;19(7):2639-2643. doi: 10.1016/j.radcr.2024.03.012. eCollection 2024 Jul.
Testicular seminoma commonly occurs in young men aged between 15 and 45 years old. Those with testicular cancer may present with a lump or swelling in the testicle. If treated and managed early, patients can expect a greater than 95% success rate. However, advanced stages of testicular seminoma can lead to eventual metastasis. We present a 45-year-old male patient with a prior history of testicular seminoma who was admitted to the emergency department with abdominal distension and acute abdominal pain. The CT identified a rather sizable abdominal mass and the biopsy confirmed metastatic testicular seminoma. Lymphoma was considered as the other differential diagnosis. Abdominal metastasis is rare in patients with testicular seminoma and usually leads to a poor survival outcome. Our patient did not attend follow-up appointments postorchidectomy, likely resulting in abdominal metastasis of testicular seminoma. This demonstrates the importance of ongoing surveillance of seminoma patients, and the challenges associated with differentiating large abdominal conglomerate mass in the CT scan. This patient is currently on active chemotherapy with bleomycin, cisplatin, and etoposide.
睾丸精原细胞瘤常见于15至45岁的年轻男性。患有睾丸癌的患者可能会出现睾丸肿块或肿胀。如果早期进行治疗和管理，患者有望获得超过95%的成功率。然而，晚期睾丸精原细胞瘤最终可能会导致转移。我们报告一名45岁男性患者，既往有睾丸精原细胞瘤病史，因腹胀和急性腹痛入住急诊科。CT检查发现一个相当大的腹部肿块，活检证实为转移性睾丸精原细胞瘤。淋巴瘤被视为另一种鉴别诊断。睾丸精原细胞瘤患者发生腹部转移较为罕见，通常会导致较差的生存结果。我们的患者在睾丸切除术后未参加随访预约，可能导致睾丸精原细胞瘤发生腹部转移。这表明了对精原细胞瘤患者进行持续监测的重要性，以及在CT扫描中鉴别大的腹部融合肿块所面临的挑战。该患者目前正在接受博来霉素、顺铂和依托泊苷的积极化疗。
