Giant Seminoma following ipsilateral orchidectomy: a rare finding. Case report

Giant intrascrotal recurrent seminomas are rare in the surgical literature, probably due to widespread information about self‐detection. A recent European study has reported a reduction in the primary tumour size at presentation. These findings are at variance with the situation in sub‐Saharan Africa. We present a 32‐year‐old patient who presented with an 8‐month history of progressive, painless left hemiscrotal swelling, no lower urinary tract symptoms and no evidence of metastatic disease. The patient had undergone a left inguinal orchidectomy 2 years prior to the onset of the current swelling, on account of a suspected testicular tumour. Histology was, however, returned as ‘sections of testis showing haemorrhagic necrosis with areas of fibrosis. No malignancy seen. Diagnosis consistent with long standing torsion’. The patient had excision of the mass via an inguinoscrotal incision, with primary wound closure and drainage, and had good post‐operative recovery. Histopathology subsequently reported seminoma. We discuss a rare case of giant intrascrotal recurrent seminoma in a young African patient and comment on the surprising absence of metastatic symptoms and the management in the absence of new imaging techniques. We emphasize the value of extirpation in such cases and the need for thorough sectioning of histopathological specimens. We also note that seminoma should be considered in the differential diagnosis of scrotal swelling even in the absence of the testes (after orchidectomy).