The great pretender: Torsion of a giant intra-abdominal seminoma presenting as acute appendicitis—A rare diagnostic trap

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Acute appendicitis may mask rare surgical emergencies. Torsion of an intra-abdominal undescended testis with malignancy is exceptionally uncommon. A 27-year-old man presented with 3 days of right lower quadrant pain, vomiting, and anorexia. Examination showed peritonitis and an absent right testis. Laparotomy for presumed appendicitis revealed a normal appendix and an 11 × 13 × 12 cm intra-abdominal mass with a 540° torsed spermatic cord. Right radical orchiectomy was performed. Histopathology confirmed classical seminoma. Final stage was pT2N0M0S0 Stage IB. Giant torsed seminoma can mimic appendicitis; genital examination is essential. abs0010