Intra-abdominal testicular teratoma complicated by torsion: A case report

A 1-year-old boy with a known left undescended testis presented with 7 days of fever, irritability, and progressive lower-abdominal distension. He was febrile and tachycardic with a firm lower-abdominal mass and an empty left hemiscrotum; white blood cells 17 × 10⁹/L, C-reactive protein 200 mg/L, platelets 680 × 10⁹/L, hemoglobin 6.8 g/dL. Ultrasound showed a heterogeneous avascular intra-abdominal mass; computed tomography showed a large cystic lesion containing fat and calcifications with a left pedicle "whirlpool sign". Urgent laparotomy with detorsion and excision revealed prepubertal-type testicular teratoma. This case highlights torsion's abdominal presentation in cryptorchidism and the value of prompt surgery and timely orchiopexy.