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A 42-year-old man presented acutely with lower abdominal peritonism and a medical history of a right orchidopexy as a child. Further history from his mother revealed that during the procedure the left testicle could not be found. In view of his unusual history and the nature of the pain a CT scan was performed demonstrating a 10×8 cm solid mass above the bladder. The mass was removed electively and revealed a torted left testicular mass. Histopathology confirmed a torted seminomatous tumour. This case highlights the importance of returning undescended testes to the scrotum or confirming absence to preserve function and ease surveillance of potential future neoplastic transformation. The current management for impalpable undescended/absent testicles involves radiological imaging, inguinal and/or laparoscopic exploration and orchidopexy before 18 months of age.

Torsion of an intraperitoneal undescended seminomatous testicular tumour