Metastatic seminoma presenting as flank pain

Area of Science:

• Oncology
• Urology
• Pathology

Background:

• Seminoma is the most frequent histological subtype of testicular germ cell tumors.
• Typically presents as a painless testicular mass, often diagnosed at an early stage.
• Metastatic presentation is less common, especially when discovered incidentally.

Purpose of the Study:

• To report a unique case of incidentally discovered metastatic testicular seminoma.
• To highlight the diagnostic and management challenges associated with elevated beta-human chorionic gonadotropin (βHCG) in this context.
• To emphasize the importance of considering testicular tumors in young men with unexplained elevated tumor markers.

Main Methods:

• Case report of a 28-year-old male patient.
• Diagnostic workup included imaging and tumor marker assessment (βHCG).
• Treatment involved radical orchidectomy followed by chemotherapy.

Main Results:

• Incidental diagnosis of metastatic seminoma following renal trauma.
• Dramatically elevated serum βHCG levels were observed.
• Post-treatment normalization of βHCG levels following orchidectomy and chemotherapy.

Conclusions:

• Metastatic testicular seminoma can present incidentally, even in the absence of typical symptoms.
• Elevated βHCG is a crucial marker in diagnosing and monitoring seminoma.
• Multimodal treatment including surgery and chemotherapy is effective in managing metastatic seminoma.