Testicular Germ Cell Tumor Presenting to the Emergency Department

Abstract

The authors report on a case of a patient who presented to the emergency department (ED) and was ultimately diagnosed with stage IV testicular non-seminomatous germ cell tumor. The patient was cachectic with a tumor on the neck, abdomen, and scrotum. Germ cell tumors (GCTs) exhibit characteristic symptoms at different points in development. Appropriate treatment can cure most GCTs. While cancer may not be thought of as an ED diagnosis, it can often be the place where patients first present, even when advanced. Recognizing it is important for prompt treatment.

A Case of Testicular Tumor Presenting as Acute Scrotum

“…In another case, the main complaint was tetraparesis for 24 hours due to spinal cord compression [ 7 ]. In both cases, the symptoms were believed to be consequences of the far metastasis of an advanced-stage testicular nonseminomatous GCT [ 3 ]. In another reported case of a young male patient who presented to the emergency department with an acute scrotum, exploration was performed due to the inability to rule out testicular torsion subcapsular arterial bleeding, and a small nonseminomatous GCT was discovered [ 4 ].…”

“…In <10% of cases, the symptoms of the metastatic disease might be the first presentation including back pain, gastrointestinal (GI) problems, and cough. In rare cases, low food intake, weight loss, and tetraparesis due to spinal cord compression have been reported [2][3][4].…”