Profound Anemia From Duodenal Invasion of Metastatic Testicular Seminoma

Metastatic Seminoma in the Duodenum: Diagnosis with Endoscopy Followed by Successful Treatment

“…Most previous cases of such lesions were diagnosed at autopsy or during abdominal surgery, while only four cases, including ours, of seminomatous metastasis to the duodenum diagnosed on endoscopy have been reported in the literature (3)(4)(5). In the present report, we describe a rare and valuable case in which we were able to confirm the diagnosis and follow the patient's clinical course using endoscopy.…”

“…In addition, Senadni et al (4) documented a case of hemodynamic deterioration due to tumor hemorrhage in which emergency surgery to stop the bleeding was required. Altamar et al also reported a case of anal bleeding and profound anemia (5.4 g/dL) in a patient with a metastatic tumor (5). In each of these previous reports, the patient's condition worsened and/or grave complications occurred due to a delay in diagnosis.…”

“…The incidence of non-seminomas is less than 5% (1), while that of pure seminomas, which are less likely than non-seminomas to metastasize to the GI tract, is less than 1% (2). Most cases of metastatic seminomas in the GI tract were diagnosed at autopsy or during abdominal surgery in past reports, and only three cases diagnosed on endoscopy prior to treatment have been reported (3)(4)(5). However, there are no reports regarding follow-up of the patient's clinical course with endoscopy after chemotherapy for the treatment of metastatic seminomas.…”

Upper Gastrointestinal Bleeding as Initial Presentation of Burned-out Testicular Tumor

“…The anatomical relationship between the involved retroperitoneal lymph nodes and the duodenum may account for the high frequency of duodenal involvement. 3,5 Germ cell tumor diagnosis is done by endoscopic and/or percutaneous biopsies in most cases with a retroperitoneal mass and GI disturbances. Metastatic testicular cancer or extragonadal GCT are the two possibilities in such a case.…”

“…Fewer than 5% of the patients with metastatic testicular cancer present with gastrointestinal (GI) involvement. 3,4,5 Testicular burned-out tumor with GI involvement is even rarer with only a few reported cases in the English literature. We present a case of testicular burned-out tumor having retroperitoneal lymph node metastases which has caused upper GI bleeding.…”