Mixed germ cell tumour of the testicle: a case report of a patient presenting with acute abdomen

Abdul Bari Shaik, Noor Fathima Shaik


Testicular tumours are a group of heterogenous neoplasms seen commonly in men between the ages of 15 and 35 years. The two main types are seminoma and non-seminomatous germ cell tumour (NSGCT). Testicular cancers are highly treatable and usually curable, even if they present at an advanced stage of the disease with a five-year survival rate of over 95 percent. The symptoms at initial presentation can vary depending on the metastasis, but a nodule or painless swelling of testicle is usually noted. In this case report we will study how a patient with metastatic testicular tumour presents with symptoms indicative of gastrointestinal infection of acute nature with no associated features. We will review current literature on testicular cancers, reasons for delay in treatment and its impact on patient care.



Testicular germ cell tumour, Metastatic cancer, NSGCT, Primary health care corporation Qatar

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Huyghe E, Matsuda T, Thonneau P. Increasing incidence of testicular cancer worldwide: a review. J urol. 2003;170(1):5-11.

Manecksha RP, Fitzpatrick JM. Epidemiology of testicular cancer. BJU int. 2009;104(9b):1329-33.

Cancer Research UK. Cancer Stats. Testicular cancer-UK. London. Cancer Res UK. 2002.

Chung PW, Gospodarowicz MK, Panzarella T, Jewett MA, Sturgeon JF, Tew-George B et al. Stage II testicular seminoma: patterns of recurrence and outcome of treatment. Eur urol. 2004;45(6):754-60.

Purdue MP, Devesa SS, Sigurdson AJ, McGlynn KA. International patterns and trends in testis cancer incidence. Int J Cancer. 2005;115(5):822-7.

Park JS, Kim J, Elghiaty A, Ham WS. Recent global trends in testicular cancer incidence and mortality. Med. 2018;97(37).

Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v2. 0 (accessed Aug 2012), Cancer incidence and mortality worldwide: IARC Cancer Base No. 10. Lyon, France. Int Agency Res Cancer. 2010.

Skakkebaek NE. Testicular dysgenesis syndrome. Hormone Res Paediatr. 2003;60(3):49.

Zhang Y, Graubard BI, Stanczyk FZ, Longnecker MP, Klebanoff MA. Maternal hormone levels among populations at high and low risk of testicular germ cell cancer. Br J Cancer. 2005;92:1787-93.

Skakkebæk N. Possible carcinoma-in-situ of the testis. Lancet. 1972;300(7776):516-7.

Giwercman A, Bruun E, Frimodt-Møller C, Skakkebaek NE. Prevalence of carcinoma in situ and other histopathological abnormalities in testes of men with a history of cryptorchidism. J urol. 1989;142(4):998-1001.

Kaatsch P, Spix C. German Childhood Cancer Registry-Annual Report 2015 (1980-2014). Institute of Medical Biostatistics. Epidemiology and Informatics (IMBEI) at the University Medical Center of the Johannes Gutenberg University Mainz. 2015.

Jones TD, Wang M, Sung MT, Zhang S, Ulbright TM, Eble JN et al. Clonal origin of metastatic testicular teratomas. Clin cancer res. 2006;12(18):5377-83.

Bojanic N, Bumbasirevic U, Bojanic G, Vukovic I, Milojevic B, Pekmezovic T. Testis sparing surgery for treatment of small testicular lesions: Is it feasible even in germ cell tumors? J Surg Oncol. 2017;115(3):287-90.

Bosl GJ, Motzer RJ. Testicular germ-cell cancer. N Eng J Med. 1997;337(4):242-54.

Lampe H, Horwich A, Norman A, Nicholls J, Dearnaley DP. Fertility after chemotherapy for testicular germ cell cancers. J Clin Oncol. 1997;15(1):239-45.

Amin MB, Edge SB, Greene F, Byrd DR, Brookland RK, Washington MK et al editors. AJCC cancer staging manual. Springer. 2017.

Baird DC, Meyers GJ, Hu JS. Testicular cancer: Diagnosis and treatment. Am family physician. 2018;97(4):261-8.

Aberger M, Wilson B, Holzbeierlein JM, Griebling TL, Nangia AK. Testicular self‐examination and testicular cancer: a cost‐utility analysis. Cancer med. 2014;3(6):1629-34.

Jones WG, Appleyard I. Delay in diagnosing testicular tumours. Bri Med J. 1985;290(6481):1550.

Walter F, Webster A, Scott S, Emery J. The Andersen Model of Total Patient Delay: a systematic review of its application in cancer diagnosis. J health services res policy. 2012;17(2):110-8.

Janz NK, Becker MH. The health belief model: A decade later. Health education quarterly. 1984;11(1):1-47.

Hopcroft K. Routine testicular self-examination: it’s time to stop. Bri med J. 2012;344:e2120.

Moore RA, Topping A. Young men's knowledge of testicular cancer and testicular self-examination: a lost opportunity? Eur j cancer care. 1999;8(3):137-42.

Shaw J. Diagnosis and treatment of testicular cancer. Am family physician. 2008;77(4):469-74.