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Chapter 9

Management of Urological Neoplastic Conditions Presenting as Emergencies

John Reynard and Hashim Hashim


Approximately 10% of cases of testicular cancer present with metastatic disease in the retroperitoneum (retroperitoneal node involvement causing back pain), chest (breathlessness, cough), and neck (enlarged cervical nodes, tracheal compression, and deviation). Spread to the central nervous system or involvement of peripheral nerves can result in neurological manifestations (Fig. 9.1). While most such cases present directly to oncologists, from time to time the urologist is the first port of call. Such cases should be referred to the oncologists as a matter of urgency for high-dose chemotherapy.

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