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Torsion of intraabdominal testicular tumors. A case report
J C Hutcheson1, R Khorasani, C C Capelouto
1Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 02115, USA.
Background:
Torsion of an intraabdominal testicular tumor is a rare event. We report a new case and review the literature.
Methods:
A review of the literature was carried out in order to identify reported cases of an intraabdominal testicular tumor undergoing torsion of its vascular pedicle. Data on histologic type, common presenting signs and symptoms, radiographic studies, and adjuvant therapy were tabulated.
Results:
There are 36 reports of an intraabdominal testicular tumor presenting with torsion. The most common histologic types, in descending order, were seminoma, sarcoma, teratoma, embryonal carcinoma, and choriocarcinoma. Common presenting signs and symptoms included pain and/or tenderness, fever, nausea and/or vomiting, and a palpable mass. Most seminoma patients received adjuvant radiation therapy whereas one patient with choriocarcinoma received adjuvant chemotherapy.
Conclusions:
Although a rare event, the diagnosis of torsion of an intraabdominal testicular tumor should be considered in any patient presenting with an acute abdomen and a history of cryptorchidism. The presence of a mass may raise the index of suspicion. Preoperative investigation with computed tomography scanning may aid surgical planning.