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| LETTER TO EDITOR |
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| Year : 2014 | Volume
: 24
| Issue : 3 | Page : 200-201 |
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Seminoma in undescended testes presenting with acute renal failure
T Ete1, S Mondal1, D Sinha1, A Nag1, A Chakraborty1, K Pan1, J Pal1, A Ghosh2
1 Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
2 Department of Medicine; Department of Rheumatology and Clinical Immunology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| Date of Web Publication | 6-May-2014 |
Correspondence Address:
S Mondal
Doctor's Hostel, 242, A.J.C Bose Road, Kolkata - 700 020, West Bengal
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0971-4065.132029
How to cite this article:
Ete T, Mondal S, Sinha D, Nag A, Chakraborty A, Pan K, Pal J, Ghosh A. Seminoma in undescended testes presenting with acute renal failure
. Indian J Nephrol 2014;24:200-1 |
How to cite this URL:
Ete T, Mondal S, Sinha D, Nag A, Chakraborty A, Pan K, Pal J, Ghosh A. Seminoma in undescended testes presenting with acute renal failure
. Indian J Nephrol [serial online] 2014 [cited 2021 Jan 20];24:200-1. Available from: https://www.indianjnephrol.org/text.asp?2014/24/3/200/132029 |
Sir,
A 17-year-old boy was admitted with a high grade fever for 2 days along with alteration in sensorium and decrease in urine volume. The fever was high grade, associated with chill and rigor. He had a huge swelling in the lower part of the abdomen, which according to his parents had been progressing over last 6 months. On examination, the patient was unconscious, febrile with a pulse rate of 110/min. Respiratory rate 26/min with acidotic pattern. There was no pallor or lymphadenopathy. Chest examination revealed bilateral coarse crepitations. Abdomen examination revealed single testes in the scrotum on the left side, a huge mass in the lower part of abdomen, firm in consistency, not fixed to overlying skin, with a side-to-side mobility. There was no pulsation or audible bruit. Cardiovascular system was normal. Routine blood report revealed hemoglobin 11.8 mg/dl, total leucocyte count 17,000/cu mm with polymorphonuclear leukocytosis, urea 234 mg/dl, creatinine 8 mg/dl. Urine showed plenty of pus cells. Patient was treated conservatively with intravenous (IV) antibiotics and IV fluids. The patient was put on dialysis and regained consciousness after 2 days. Ultrasonography showed a huge retroperitoneal mass with bilateral hydroureteronephosis. No lymphadenopathy could be documented. Right scrotal sac was empty with a normal left testis. A non-contrast computed tomography scan revealed ovoid well-defined, soft-tissue attenuation mass, measuring about 101 mm × 127 mm in the midline of the lower abdomen, with absent right spermatic cord [Figure 1]. The impression was, testicular carcinoma arising from the right intraabdominal undescended testis. At the end of 1 st week, there was an improvement of clinical condition with normalization of total leucocyte count and his serum urea and creatinine values came down to 43 mg/dl and 1.6 mg/dl respectively. After stabilization of patient's condition, the patient underwent orchiedectomy followed by radiotherapy. Histopathologically, the mass was confirmed as seminoma. | Figure 1: Non contrast computed tomography scan of abdomen showing large pelvic mass (marked)
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Seminoma affects young men typically between the ages of 30 and 55 years and accounts for approximately 50% of testicular germ cell tumors. The cure rates is very high due to its extreme sensitivity to chemotherapy and radiotherapy. [1] The prognosis of pure seminoma is excellent. [2] Majority of undescended testes are located distal to the external inguinal ring and they are palpable. Non-palpable undescended testes are generally located in the inguinal canal, but a very few of them are located intra-abdominally. [3] About 66% of undescended testes are located distally to the external inguinal ring, 16% in the inguinal canal, 10% are intraabdominal and 3% are surgically absent. [4] As seminoma of testes is common between 30 and 55 years of age with pure seminoma being rare, here we are presenting a case of pure seminoma testes admitted with urinary tract obstruction leading to urinary stasis and urosepsis leading to acute renal failure.
| References | |  |
| 1. | Alexander EJ, White IM, Horwich A. Update on management of seminoma. Indian J Urol 2010;26:82-91. 
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| 2. | Boujelbene N, Cosinschi A, Boujelbene N, Khanfir K, Bhagwati S, Herrmann E, et al. Pure seminoma: A review and update. Radiat Oncol 2011;6:90.
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| 3. | Woodward PJ. Case 70: Seminoma in an undescended testis. Radiology 2004;231:388-92.
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| 4. | Lee JK, McClennan BL, Stanley RJ, Sagel SS. Utility of computed tomography in the localization of the undescended testis. Radiology 1980;135:121-5.
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[Figure 1]
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