title: A Torted Ruptured Intra-abdominal Testicular Seminoma Presenting As An Acute Abdomen.
abstract: The susceptibility of the undescended testis to malignant transformation is well documented. The most common location of the undescended testis is within the inguinal canal, with only a minority located within the abdominal cavity. When a testicular mass develops, the risk of torsion increases. We describe a large intra-abdominal testicular seminoma that had undergone torsion, rupture and haemorrhage, presenting as an acute abdomen. A 30 year old man presented to the emergency department with right iliac fossa pain. Computed tomography in the emergency department showed haemoperitoneum and a torted large left testicular mass, likely malignant. The patient underwent laparotomy and excision of the mass. Histologic examination revealed a grossly enlarged seminomatous testis which had torted and ruptured. While pre-operative imaging diagnosis of an intra-abdominal testicular seminoma has been published, reports are few. To the best of the author's knowledge pre-operative imaging diagnosis of a malignant testicular mass with torsion and intra-abdominal haemorrhage presenting as an acute abdomen has not been described before.
authors.affiliation: Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
authors.forename: Oliver James
authors.initials: OJ
authors.lastname: Nickalls
authors.affiliation: Department of Pathology, National University Hospital, Singapore.
authors.forename: Char Loo
authors.initials: CL
authors.lastname: Tan
authors.affiliation: Department of Diagnostic Radiology, National University Hospital, Singapore.
authors.forename: Yee Liang
authors.initials: YL
authors.lastname: Thian
mesh_terms: D000006:Abdomen, Acute / Q000000981:diagnostic imaging* / Q000601:surgery; D000328:Adult; D003456:Cryptorchidism / Q000000981:diagnostic imaging* / Q000601:surgery; D003937:Diagnosis, Differential; D006465:Hemoperitoneum / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D012421:Rupture; D018239:Seminoma / Q000000981:diagnostic imaging* / Q000601:surgery; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000000981:diagnostic imaging* / Q000601:surgery
keywords: CT; Cryptorchidism; acute abdomen; intra-abdominal testicular seminoma; intra-abdominal testicular torsion; intraperitoneal haemorrhage; testicular torsion; undescended testis