Vision Loss as Presenting Symptom in Testicular Cancer: A Morbid Case Report
Testicular cancer is the most common malignancy in men 20–40 years old and most commonly metastasizes to the lung, liver, and brain. Choroidal metastasis from testicular cancer is exceedingly rare, and only few cases have been described in the literature. We report a patient who presented with painf...
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| Format: | Article |
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Karger Publishers
2022-09-01
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| Series: | Case Reports in Ophthalmology |
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| Online Access: | https://www.karger.com/Article/FullText/526748 |
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| author | You Zhou Ardalan Sharifi Praveena Gupta Brittany Duong Arian Pourmehdi Lahiji Jing He Wen-Hsiang Lee |
| author_facet | You Zhou Ardalan Sharifi Praveena Gupta Brittany Duong Arian Pourmehdi Lahiji Jing He Wen-Hsiang Lee |
| author_sort | You Zhou |
| collection | DOAJ |
| description | Testicular cancer is the most common malignancy in men 20–40 years old and most commonly metastasizes to the lung, liver, and brain. Choroidal metastasis from testicular cancer is exceedingly rare, and only few cases have been described in the literature. We report a patient who presented with painful unilateral vision loss as the initial presenting symptom of metastatic testicular germ cell tumor (GCT). A 22-year-old Latino man presented with a 3-week history of progressive central vision loss and dyschromatopsia, accompanied by intermittent, throbbing ocular, and periocular pain, in the left eye. Associated symptom was remarkable for abdominal pain. Examination of the left eye disclosed light perception vision and a large choroidal mass in the posterior pole involving the optic disk and the macula with associated hemorrhages. Neuroimaging showed a 2.1-cm lesion in the posterior globe of the left eye, and B-scan and A-scan ultrasonography findings were consistent with choroidal metastasis. Systemic workup revealed a mass in the left testicle with metastasis to the retroperitoneum, lungs, and liver. Biopsy of a retroperitoneal lymph node showed a GCT. Visual acuity worsened from light perception to no light perception 5 days following initial presentation. Several cycles of chemotherapy were completed, including salvage therapy; however, these treatments were unsuccessful. While vision loss due to choroidal metastasis as the initial presenting symptom of testicular cancer is rare, clinicians should consider metastatic testicular cancer in the differential diagnoses in patients with choroidal tumors, especially in young men. |
| first_indexed | 2024-04-12T14:47:31Z |
| format | Article |
| id | doaj.art-de0f705205ee4dfcbea412b5b4a91b75 |
| institution | Directory Open Access Journal |
| issn | 1663-2699 |
| language | English |
| last_indexed | 2024-04-12T14:47:31Z |
| publishDate | 2022-09-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Ophthalmology |
| spelling | doaj.art-de0f705205ee4dfcbea412b5b4a91b752022-12-22T03:28:36ZengKarger PublishersCase Reports in Ophthalmology1663-26992022-09-0113375676210.1159/000526748526748Vision Loss as Presenting Symptom in Testicular Cancer: A Morbid Case ReportYou Zhou0Ardalan Sharifi1Praveena Gupta2Brittany Duong3Arian Pourmehdi Lahiji4Jing He5https://orcid.org/0000-0002-4229-6327Wen-Hsiang Lee6Department of Ophthalmology & Visual Sciences, University of Texas Medical Branch, Galveston, TX, USADepartment of Ophthalmology & Visual Sciences, University of Texas Medical Branch, Galveston, TX, USADepartment of Ophthalmology & Visual Sciences, University of Texas Medical Branch, Galveston, TX, USADepartment of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USADepartment of Pathology, University of Texas Medical Branch, Galveston, TX, USADepartment of Pathology, University of Texas Medical Branch, Galveston, TX, USADepartment of Ophthalmology & Visual Sciences, University of Texas Medical Branch, Galveston, TX, USATesticular cancer is the most common malignancy in men 20–40 years old and most commonly metastasizes to the lung, liver, and brain. Choroidal metastasis from testicular cancer is exceedingly rare, and only few cases have been described in the literature. We report a patient who presented with painful unilateral vision loss as the initial presenting symptom of metastatic testicular germ cell tumor (GCT). A 22-year-old Latino man presented with a 3-week history of progressive central vision loss and dyschromatopsia, accompanied by intermittent, throbbing ocular, and periocular pain, in the left eye. Associated symptom was remarkable for abdominal pain. Examination of the left eye disclosed light perception vision and a large choroidal mass in the posterior pole involving the optic disk and the macula with associated hemorrhages. Neuroimaging showed a 2.1-cm lesion in the posterior globe of the left eye, and B-scan and A-scan ultrasonography findings were consistent with choroidal metastasis. Systemic workup revealed a mass in the left testicle with metastasis to the retroperitoneum, lungs, and liver. Biopsy of a retroperitoneal lymph node showed a GCT. Visual acuity worsened from light perception to no light perception 5 days following initial presentation. Several cycles of chemotherapy were completed, including salvage therapy; however, these treatments were unsuccessful. While vision loss due to choroidal metastasis as the initial presenting symptom of testicular cancer is rare, clinicians should consider metastatic testicular cancer in the differential diagnoses in patients with choroidal tumors, especially in young men.https://www.karger.com/Article/FullText/526748nonseminomatous germ cell tumorchoroidmetastasistesticular carcinoma |
| spellingShingle | You Zhou Ardalan Sharifi Praveena Gupta Brittany Duong Arian Pourmehdi Lahiji Jing He Wen-Hsiang Lee Vision Loss as Presenting Symptom in Testicular Cancer: A Morbid Case Report Case Reports in Ophthalmology nonseminomatous germ cell tumor choroid metastasis testicular carcinoma |
| title | Vision Loss as Presenting Symptom in Testicular Cancer: A Morbid Case Report |
| title_full | Vision Loss as Presenting Symptom in Testicular Cancer: A Morbid Case Report |
| title_fullStr | Vision Loss as Presenting Symptom in Testicular Cancer: A Morbid Case Report |
| title_full_unstemmed | Vision Loss as Presenting Symptom in Testicular Cancer: A Morbid Case Report |
| title_short | Vision Loss as Presenting Symptom in Testicular Cancer: A Morbid Case Report |
| title_sort | vision loss as presenting symptom in testicular cancer a morbid case report |
| topic | nonseminomatous germ cell tumor choroid metastasis testicular carcinoma |
| url | https://www.karger.com/Article/FullText/526748 |
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