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ISSN 2305-7939 (Electronic)

2017, Number 2

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RCU 2017; 6 (2)

Spermatocytic metastatic seminoma mimicking acute infectious epididymo‐ orchitis

Rodríguez CTL, Darias MJL, Portales CY, Casa de Valle CM

Language: Spanish
References: 14
Page: 106-113
PDF size: 956.40 Kb.


ABSTRACT

Introduction: Spermatocytic seminoma is scarce and more common in elder men. Objectives: To describe the clinic and imaginologic characteristics, and the treatment applied to a patient with a spermatocytic seminoma diagnosis. Case presentation: A 66 ‐ year‐ old patient with a history of arterial hypertension, smoker and hard drinker. He came to the Urology external consulting room suffering from a volume increase and pain in the right testicle with chills and dysuria. On physical exam the right testicle, epididymis and the spermatic cord were increased in size and consistency, and painful by touch. This situation was interpreted as an infectious epididymo‐ orchitis and the adecuate treatment was indicated. Two weeks later, the increase in volume and consistency persisted. He was manteined on local cold fomentation and oral anti‐ inflamatories. After a month of evolution and due to the continuation of the consistency increase already mentioned, a testicular ultrasound was ordered that showed several hypoecogenic testicular tumoral lesions. The thorax‐ abdominal tomography showed periaortic and pericava adenopathies with metastatic aspect. All the studies in the hematic series were normal. The lactic deshidrogenase was the only positive tumoral marker. Results: The right radical orchiectomy via inguinal was performed. The hystopathological report was spermatocytic seminoma. The postoperative evolution was satisfactory. He was remitted to the oncologist for specific medical treatment. Conclusions: Acute infectious epididymo‐ orchitis can mask the presence of a testicular tumor in elder men, on whom low obstructive urinary symptoms are superinduced which may cause infections in the urogenital tract.


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