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Artículos
Publicado el 1 de octubre de 2002
Caso Clínico
Diagnóstico post-morten de carcinoma testicular después de accidente de tránsito
La demora en el diagnóstico de carcinoma testicular puede implicar una disminución en la sobrevida.
Autor/a: Dres. de Boer HD, Haerkens MH, van der Stappen W, van Ingen G
En este paciente, la masa retroperitoneal hallada en la ecografía fue inicialmente considerada erróneamente como un hematoma por el antecedente del traumatismo reciente. Los hematomas retroperitoneales generalmente quedan confinados en ese espacio, sin embargo, un hematoma expansivo puede seguir el saco inguinal y producir una masa inguinoescrotal [3].
El sarcoma retroperitoneal, linfoma maligno y quistes pancreáticos pueden todos causar masas retroperitoneales.
Este paciente falleció por un embolismo pulmonar masivo causado probablemente por la invasión de la vena cava inferior de un carcinoma testicular metastático. Esto demuestra la importancia del examen post-morten para confirmar el diagnóstico clínico.
El reconocimiento temprano del carcinoma testicular es esencial y se ha comprobado que la demora de más de 3 meses se correlaciona con una disminución significativa de la tasa de sobrevida a 5 años [4]. El retardo en el diagnóstico puede obedecer a diversos factores, incluyendo la falta de conocimiento del paciente, vergüenza, ignorancia, miedo al cáncer y a la emasculación [5].