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We present a 3-month-old baby with a cryptorchid left testicle who was referred to our institution with fever, anorexia, abdominal distension and right lower quadrant abdominal tenderness. There had been similar clinical signs 6 weeks earlier, but no imaging had been performed. Abdominal radiograph showed a small area of calcification in the right lower quadrant (Fig. 1). US showed a partly solid and partly cystic circumscript mass with a small focus of calcification (arrow) in the right iliac fossa (Fig. 2). On Doppler US no flow was detected.
The diagnosis of a tumour arising in a torqued cryptorchid left testicle was postulated. At surgery the left testicle, containing a mass, was found in the right iliac fossa. Histopathological examination showed an immature teratoma in a torqued cryptorchid testicle. In retrospect, alpha-1-fetoprotein on the day of admission was 4,907 µg/l (normal range 0–10); it normalized after resection of the tumour.
It is well known that the risks of developing testicular cancer as well as torsion are increased in cryptorchid testicles [1, 2]. Although previously reported in the literature, the presentation of this case is relatively rare and initially the diagnosis was missed.
IRB approval to publish this case was waived.
References
Herrinton LJ, Zhao W, Husson G (2003) Management of cryptorchism and risk of testicular cancer. Am J Epidemiol 157:602–605
Wright JE (1986) Impalpable testes: a review of 100 boys. J Pediatr Surg 21:151–153
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Open Access This is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License (https://creativecommons.org/licenses/by-nc/2.0), which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
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Van Rijn, R.R., Merks, J.H.M. Cryptorchid testicular tumour presenting as an acute abdomen in an infant. Pediatr Radiol 41, 130 (2011). https://doi.org/10.1007/s00247-010-1631-9
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DOI: https://doi.org/10.1007/s00247-010-1631-9