Acute presentation of metastatic testicular seminoma as chronic subdural hematoma with extra-axial brain lesion with severe mass effect: A case report and brief review of literature

Abstract

We present an unusual case of a 33-year-old male, who has been diagnosed with seminoma testes with retroperitoneal lymph nodes involvement 1 year back, the patient had undergone four cycles of the chemotherapy and had undergone left orchidectomy for the same. Past 1 year was uneventful and the patient was living a normal healthy life, with no evidence of any diseases and no symptoms. For the last 1 month, the patient complained of headache with no other symptoms, and on 1 day, the patient had sudden loss of consciousness. Noncontrast computed tomography (CT) head was done, which revealed a large chronic subdural collection with an extra-axial mass attached with the dura on the right parasagittal region. The patient at the time of presentation had a Glasgow Coma Scale of 5/15 with irregular respiration, and the right pupil was fixed nonreacting to the light. Urgent surgery was done, and the patient recovered fully with no deficit and was discharged. The patient will be considered for chemotherapy.

Keywords

• brain metastasis
• chronic subdural hematoma
• seminoma