PDF(Pubmed)
Abstract：
Testicular neoplasms, or testicular cancer, are not typically seen in the emergency department (ED) since their presentation involves a painless hard mass that emerges slowly over time. Uncommon presentation of testicular neoplasm to the ED with acute onset of scrotal pain may present challenges as an incomplete physical examination without supplemental imaging and laboratory workup may overlook the diagnosis of testicular neoplasm. As a result, a delay in proper treatment may occur. Early recognition of testicular neoplasm can decrease morbidity and mortality and improve overall patient survival. Here, we present a case of a 32-year-old male who presented in the ED with an acute onset of testicular pain localized on the posterior right side of the scrotum. Despite the unusual presentation, a complete physical examination, including a complete genitourinary system exam, was performed. During the physical examination, a high index of suspicion for testicular neoplasm was present. Necessary imaging and laboratory workup were ordered. Based on the findings, testicular neoplasm was highly suspected. Thus, surgical intervention was pursued to remove the suspicious mass and pathology revealed a mixed germ cell tumor. Further imaging and laboratory workup showed metastasis into other organ systems, and medical management was chosen to treat the metastatic neoplasm systemically.
摘要：
睾丸肿瘤,或者睾丸癌,通常不会在急诊科（ED）中看到，因为它们的介绍涉及无痛的硬块，随着时间的流逝而缓慢出现。在阴囊疼痛急性发作的ED中，睾丸肿瘤的罕见表现可能会带来挑战，因为没有补充影像学和实验室检查的不完整体检可能会忽略睾丸肿瘤的诊断。因此,可能会延迟适当的治疗。睾丸肿瘤的早期识别可以降低发病率和死亡率，并提高患者的总体生存率。这里,我们介绍了一例32岁男性患者,他在ED中出现急性睾丸疼痛,位于阴囊右后侧.尽管有不寻常的介绍，完整的体检,包括完整的泌尿生殖系统检查,已执行。在体检期间,存在对睾丸肿瘤的高度怀疑。订购了必要的成像和实验室检查。根据调查结果,高度怀疑睾丸肿瘤。因此，进行手术干预以清除可疑肿块，病理显示混合生殖细胞肿瘤。进一步的成像和实验室检查显示转移到其他器官系统，并选择药物治疗系统治疗转移性肿瘤。
