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GENITOURINARY IMAGING Table of Contents   
Year : 2004  |  Volume : 14  |  Issue : 3  |  Page : 299-300
Case report : Seminoma in abdominal ectopic testis


Department of Radiology and Imaging, V.S. General Hospital, Smt. N.H.L Municipal Medical College, Ahmedabad-380006, India

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Keywords: Seminoma, Ectopic Testis

How to cite this article:
Shah M S, Patel L N, Shah R R, Bhatt C, Modi J. Case report : Seminoma in abdominal ectopic testis. Indian J Radiol Imaging 2004;14:299-300

How to cite this URL:
Shah M S, Patel L N, Shah R R, Bhatt C, Modi J. Case report : Seminoma in abdominal ectopic testis. Indian J Radiol Imaging [serial online] 2004 [cited 2019 Jul 17];14:299-300. Available from: http://www.ijri.org/text.asp?2004/14/3/299/28607

   Introduction Top


Seminoma is the commonest germ cell tumor (GCT) in ectopic testis. Its very uncommon presentation is large retroperitoneal mass [1], which is frequently associated with renal agenesis [2].

Here, we report a case of seminoma which was detected in middle aged patient, but without renal agenesis.


   Case report Top


A 42 year old male patient came to hospital with c/o abdominal pain around umbilicus.

On clinical examination a mass was palpable in left lumbar region and testis was palpable only in right scrotal sac.

Sonography performed with 3.5 MHz curvilinear probe showed large welldefined complex mass with central large echogenic area seen in left lumbar region extending across the midline, surrounding the aorta. The mass lesion displaced the left kidney downwards and laterally, obstructing the left ureter and causing hydronephrosis of left kidney. Mass lesion extended upto anterior abdominal wall and below upto the level of iliaccrest on both side. [Figure - 1]

USG of scrotum was performed which showed normal right testis, absent left testis with testis not detected in any other ectopic site.[Figure - 2]

Diagnosis of large retroperitoneal mass was considered. CT scan of abdomen and pelvis was performed CT scan shows welldefined soft tissue density lesion in the retroperitoneum involving perinephric space & posterior pararenal space, extending anteriorly upto anterior abdominal wall and downward upto illiac crest. Mass lesion was completely encircling the aorta, displacing left kidney downwards and laterally, obstructing left ureter and causing hydronephrosis of left kidney. Mass lesion showed inhomogenous enhancement on post contrast studv.[Figure - 3],[Figure - 4]

Under local anaesthesia tru-cut biopsy of mass lesion under USG guidance was performed. Biopsy report was seminoma [Figure - 5]


   Discussion Top


In humans, testis develop in the abdomen and normally descends into lower portion of scrotum during 3rd trimester. The testis may descend normally from the abdomen, or may be misguided to an abnormal position outside the external inguinal ring (due to abnormal gubernaculum). This constitutes testicular ectopia and is uncommon [3].

Most common ectopic location is (a) superficial inguinal pouch (b) a subcutaneous pocket infront and lateral to external inguinal ring and very rarely in abdomen [3].

Testicular GCTs are very rare, 1-2% of all malignancy in male. seminoma is the commonest GCTs (40%), but it is very rare in abdomen [1].

Patients with H/.o of cryptorchidism have a 10-40 times increased risk of seminoma. Risk is greater for abdominal versus, inguinal region of undescended testis [1].

Its Uncommon presentation is large Retroperitoneal mass [1] or Abdominal mass [2]

Abdominal testis is more likely to be a seminoma[1] But when they arise they are frequently associated with Renal agenesis [2].

Current examination of choice is computed Tomography [2]; show large soft tissue density retroperitoneal mass lesion; but not possible to see the ectopic testis.

Advisable to do USG scrotum of normal testis to rule out seminoma.

Exploratory laparotomy and subsequent pathology examination is diagnostic [4].

Lab. studies such as increased AFP is confirmatory for pure seminoma. Other markers such as LDH also useful but it is less specific and B-HCG increased with metastic disease [5].


   Conclusion Top


Thus in case of retroperitoneal mass lesion with undescended testis, possibility of seminoma should be considered.

 
   References Top

1.E medicine Journal, Testicular seminoma, article by John W. Davis, MD Topic 2250. www.emedicine.com/med.htm.94G.   Back to cited text no. 1    
2.Seminoma on ectopic testis asso. With Renal agenesis Journal of Radiology, 1982, Dec.63(12) : 763-51, French.  Back to cited text no. 2    
3.Encyclopaedia of Medical Imaging volume IV-2  Back to cited text no. 3    
4.Seminoma complicating undescended intrabdominal testis AJR : 2000, 175: 1186-87. Wolffon buttel et al.Ann.J. Madernac.  Back to cited text no. 4    
5.Cryptocorchidism and Testicular cancer, Journal of Urology, 1980; 124 : 382-7, Batata MA, Whitemore JROF, Chu Fch, Hilaris BS, LohJ, Grabstald H et al.  Back to cited text no. 5    

Top
Correspondence Address:
M S Shah
Department of Radiology and Imaging, V.S. General Hospital, Smt. N.H.L Municipal Medical College, Ahmedabad-380006
India
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Source of Support: None, Conflict of Interest: None


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    Figures

[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5]



 

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    Introduction
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    Discussion
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    References
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