Massive hemorrhage from spontaneous rupture of a retroperitoneal lymph node in patient with metastatic mixed germ cell tumor

Urology
Katherine MooreStéphane Bolduc

Abstract

Spontaneous hemoperitoneum secondary to metastatic foci of testicular germ cell tumor is a rare finding and is usually precipitated by the beginning of chemotherapy treatments. This acute presentation is usually due to the rupture of hepatic or gastrointestinal metastasis. We present the case of a 16-year-old boy who was admitted to the emergency room with acute abdominal pain and unstable vital signs, 10 days after a left orchiectomy for a testicular mixed nonseminomatous tumor. An urgent laparotomy demonstrated a significant peritoneal effusion (3 L) secondary to a ruptured retroperitoneal lymph node. More than 90% of the mass was resected with 3 cm of adherent jejunum. Pathologic findings revealed the mass to be composed of more than 95% of choriocarcinoma. The patient recovered well from the surgery and received standard chemotherapy with good response and no residual disease. Two and a half years after diagnosis, the patient is still in remission.

References

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May 4, 2002·The Journal of Trauma·Hasan Fehmi KüçükMustafa Gülmen
Feb 29, 2008·International Journal of Urology : Official Journal of the Japanese Urological Association·Manabu TatokoroHideki Akamatsu

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Citations

Nov 25, 2014·Indian Journal of Surgical Oncology·Senthil Kumar Azhisoor Chandrasekhar, Narayanaswamy Kathiresan
Sep 28, 2014·Pathology Oncology Research : POR·Hajnalka NémethLajos Géczi
Feb 1, 2017·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Young Min ChoiMin Jung Kim
Apr 15, 2011·Current Opinion in Oncology

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