Renal germ cell metastatic tumour with rupture, bleeding and syncope: an unusual clinical presentation in a young patient

The most common malignancy in young men is a germ cell tumour of the testes. Metastatic renal disease is relatively uncommon and usually manifests in the retroperitoneal lymph nodes. Visceral metastases to the liver, and metastases to the lungs and the brain are more common. Few large studies characterising patients with germ cell tumours and associated renal metastases have yet been published. We report an unusual case of successful management, through demolitive surgery, of a 22-year-old male patient affected by spontaneous intrarenal rupture of metastases secondary to testicular cancer. The patient was admitted to our urology department due to recurrent episodes of haematuria and clinical symptoms of persistent hypotension.