Coffee grounds emesis: Rare presentation of testicular cancer treated with neoadjuvant chemotherapy

Fewer than 5% of patients with metastatic testicular cancer present with gastrointestinal involvement. Even rarer is testicular metastasis to the duodenum. We present the case of a previously healthy 26-year-old man who had symptomatic gastrointestinal bleeding caused by metastatic testicular cancer. He was treated with orchiectomy, cisplatin-based neoadjuvant chemotherapy, and finally, resection of the residual retroperitoneal mass. We believe that neoadjuvant chemotherapy, followed by surgical debulking, is the appropriate therapeutic sequence when treating an otherwise stable patient with metastatic testicular tumor involving the gastrointestinal tract.