Cryptorchid testicular tumour presenting as an acute abdomen in an infant.

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.

Fig. 1

Plain abdominal radiograph

Fig. 2

US image of the tumour

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.