Typical and Atypical Presentations of Testicular Carcinoma

Testicular carcinoma most commonly presents as a testicular mass. Approxiately 10-15% of patients, however, present with manifestations of metastatic disease. The reported clinical presentations of metastatic testicular carcinoma are varied and include abdominal mass, hemoptysis, adenopathy, respiratory difficulty, anorexia, nausea, vomiting, lumbar back pain, and lower extremity swelling. A comprehensive review of the literature indicated that testicular carcinoma presents as a testicular abnormality 90% of the time. In 10% of cases, however, the patients will present with nontesticular manifestations of metastatic disease. The authors provide a summary of reported nontesticular presentations of testis cancer and describe a unique case wherein the clinical presentation was spontaneous ejaculatory failure.