Testicular carcinoma: postmortem diagnosis after a car accident

The combination of early detection and chemotherapy gives a 10-year survival of 88%, making it one of the most effectively-- treated ontological diseases.1 Inferior venal caval thrombus from direct invasion of retroperitoneal metastasis and concomitant massive pulmonary embolism is rare.2 In our patient, the retroperitoneal mass found on ultrasonography was initially misdiagnosed as a retroperitoneal haematoma due to the trauma which the patient had sustained a few days earlier. Retroperitoneal haematomas are usually confined to the retroperitoneal space. However, an expanding haematoma can track to the inguinal sac producing an inguinal and scrotal mass., Retroperitoneal sarcoma, malignant lymphoma, and pancreatic cysts can all cause retroperitoneal masses. Our patient died from massive pulmonary embolism probably caused by metastatic testicular carcinoma invading the inferior vena cava. This tragic case reminds us that a postmortem examination is essential to confirm a clinical diagnosis. Early recognition of testicular carcinoma is essential as it has been shown that a treatment delay of more than 3 months is correlated with a significantly decreased 5-year survival rate.' Delay in diagnosis may depend on several factors including patient's lack of knowledge, embarrassment, ignorance, or fear of cancer and of emasculation.'