International Journal of Hematology and Oncology 2023, Vol 33, Num 4 Page(s): 245-248
Upper Gastrointestinal Bleeding as Initial Presentation of Burned-out Testicular Tumor

Haldun KAR1, Erdinc KAMER1, Nese EKINCI2, Cengiz GIRGIN3, Mehmet A. ONAL1, Murat ERMETE2

1Ataturk Training and Research Hospital, Department of 4th General Surgery, Izmir, TURKEY
2Ataturk Training and Research Hospital, 2nd Pathology, Izmir, TURKEY
3Ataturk Training and Research Hospital, 1st Urology, Izmir, TURKEY

Keywords: Burned-out, Gastrointestinal bleeding, Metastatic testicular neoplasm, Testicular germ cell tumor
We report a case of 33-year-old man who initially presented with upper gastrointestinal bleeding caused by metastatic testicular cancer. Physical examination was significant for a palpable abdominal mass. Emergency gastroduodenoscopy yielded an ulcerated infiltrating mass in the third portion of the duodenum. Computerized tomography of the abdomen demonstrated a retroperitoneal mass. Histological examination of the retroperitoneal mass biopsy showed a nonseminamatous germ cell tumor consisting of embryonal cell carcinoma. Examination of the testes revealed a normal-sized firm left testis, and a normal right one. Ultrasonography of the testes showed multiple left testicular calcifications. The patient underwent left radical inguinal orchiectomy and histological examination of the resected testis showed spontaneous regression of testicular germ cell tumor. We suppose that the tumor was a so-called “burned-out” testicular tumor. He was treated with four courses of chemotherapy with cisplatin, etoposide and bleomycin. At five year follow-up, the patient was doing well, with no recurrens.