Metastatic Testicular Cancer Patient with Synchronous Oral Squamous Cell Carcinoma Presented with Gastrointestinal Bleeding: A Case Report

Testicular cancer is a curable oncologic disease of males mostly aged 15-44 years. Most of the patients are successfully treated with radical orchiectomy. However, a delayed presentation may lead to a dismal prognosis. There are several risk factors including cryptorchidism, a first-degree relative with testicular cancer, hypospadias, childhood inguinal hernia, and military pollutant exposure, among others. The distant metastasis of testicular carcinoma to the lung, liver, and brain are widely described. We present a unique case of a 28-year-old male who presented with gastrointestinal (GI) bleeding. Later, it was discovered that he had a metastatic testicular carcinoma synchronous with an oral squamous cell carcinoma. Metastasis was detected by imaging including X-ray, computerized tomography (CT) of the chest, abdomen, and brain magnetic resonance imaging (MRI). The presence of two primary cancers concurrently is rare and indicates a poor prognosis. Because of the absence of risk factors in this patient, he was thought to be potentially exposed to depleted uranium from warfare due to his residence in Iraq. Markedly raised beta-human chorionic gonadotropin (b-HCG) titers indicate a possible nonseminomatous type; however, the exact type is unknown as the patient declined fine needle aspiration (FNA)/biopsy and orchiectomy. This case focuses on the atypical presentation and the importance of when to seek medical attention, as a delayed presentation can lead to a poor prognosis. Moreover, it heightens awareness that other malignancies may occur concurrently. As well as to emphasize on means that can be used to educate high-risk groups.