Undescended Testicular Seminoma Presenting as an Intra-Abdominal Mass - A Case Report

Abstract

Cryptorchidism is a common congenital malformation of the male genitourinary tract. The malignant potential of cryptorchidism in undescended testes is ten percent with the risk being highest in intra-abdominally located testes. In our case report, a 25-year-old man presented with a lower abdominal mass, which was nontender and of two months duration. Physical examination of the scrotum revealed an empty left scrotum and inguinal canal. Computed tomography scan, exploratory laparotomy and histopathological examination revealed an intrabdominal testicular seminoma (germ cell tumour). The purpose of our case report is to highlight the need for routine scrotal examination in addition to routine physical examination in all men who present with an abdominal mass to rule out the possibility of an intraabdominal testicular neoplasm. Cryptorchidism is defined as the absence of one or both testes from the scrotal sac and is one of the most frequently encountered birth defects of the male genitalia.1 The prevalence amongst full-term neonates is three percent and 30 % in preterm neonates.2 There is a higher potential for malignant transformation for cryptorchid testes than normally descended testes. They also predispose to ischemia and infertility later in adulthood.3 Seminoma (germ cell tumour) is the most common malignant transformation of an undescended testis.4 A 25-year-old male complaining of a painless, slow-growing abdominal mass found to have intraabdominal testicular seminoma in an undescended testis and confirmed histopathologically, is presented in this case report. We wanted to highlight the importance of considering testicular germ cell tumours in the abdomen and the importance of performing a groin examination in a patient presenting with an abdominal lump with an empty scrotal sac.