Testicular tumor with gastrointestinal hemorrhage

We report a case of a 37-year-old man who presented with signs of gastrointestinal hemorrhage. Emergency endoscopy revealed a bleeding tumor in the duodenum. The history and physical investigation showed a tumor in the right testis. Computed tomography demonstrated multiple metastases, including retroperitoneal bulk infiltrating the duodenum. The histologic evaluation proved a germ cell tumor. After testicular ablation, immediate chemotherapy was started. After a partial remission, the patient died of progressive metastatic disease 11 months later. This is only the second published case of a metastatic germ cell tumor diagnosed by severe anemia resulting from gastrointestinal hemorrhage