[Intra-abdominal torsion of the testis with seminoma]

A 38-year-old man presented with acute onset of left iliac fossa pain. He had never noticed a left testis. An ultrasound scan showed a solid pelvic mass. Alfafoetoprotein and HCG were normal. Laparotomy for an acute abdomen was performed and revealed torsion of the left intra-abdominal testis. A left orchiectomy was performed. The patient made an uneventful recovery. Histology showed seminoma and carcinoma in situ. A testicular biopsy from the right testis showed no malignancy. A detailed examination of the genitalia should be part of the usual abdominal examination.