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Case Reports 2018 Medical Case Reports
ISSN: 2471-8041 Page 39
May 28-29, 2018
London, UK
8th Edition of International Conference on
Clinical and Medical Case Reports
T esticular cancer is an increasingly prevalent cancer especially
amongst young and middle-aged men. Most commonly it
presents as a painless mass but atypical presentations are well-
known and have been reported in the literature. A45-year-oldmale
presented with acute periumbilical pain. After an unremarkable
clinical examination of the abdomen and genitalia, an abdominal
computerised topography (CT) scan showed a solitary enlarged
para-aortic lymph node (30 mm) and ultrasound scan (USS)
showed a 15x6x11 mm left-sided testicular lesion. Tumour
markers were normal. CT-guided biopsy of the para-aortic lymph
node revealed metastatic deposits from classical seminoma. We
hereby discuss possible mechanisms of an enlarged para-aortic
lymph node causing periumbilical/abdominal pain with reference
to the normal anatomical structures present in the vicinity of the
para-aortic lymph nodes in the retroperitoneum. We also present
our findingsof a litreature reviewof similar casepresentations and
discuss the comparison between those cases and the index case.
We conclude that clinicians should undertake careful assessment
of the genitals routinely when assessing men presenting with
acute abdominal pain, and consider a testicular USS to exclude
impalpable lesions, particularly when the clinical presentation is
inconsistent with acute abdominal visceral pathology.
Biography
Angela Yan and Zhi Yang Low are both final year medical students at UCL
with a keen interest in research and surgery. They will both be starting their
foundation training in August; Miss Yan will be starting an Academic Foun-
dation Programme post in Leicester and Mr Low will be working in London.
Dr Dhili Arul is a consultant histopathologist at Whittington Health NHS
Trust. Mr Sudhanshu Chitale is a consultant urologist and Lead for the Urol-
ogy Paediatric and Joint Urology Diabetes Service and Male Fertility. He is
also an Honorary Senior Lecturer at UCL.
Mechanism of unusual presentation of testicular tumour:
case study and literature review
Angela Yan, Zhi Yang Low, Dhili Arul and Sudhanshu Chitale
Whittington Health NHS Trust - UCL Medical School, UK
Angela Yan et al., Med Case Rep. 2018, Volume 4
DOI:10.21767/2471-8041-C1-002
Figure1: Immunohistochemical staining of the tumour with hema-
toxylin and eosin (H&E) revealed seminoma cells