<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452023000400059</article-id>
<article-id pub-id-type="doi">10.1159/000526427</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Testicular Seminoma Presenting as Gastrointestinal Bleeding: A Rare Cause of Metastatic Disease in the Stomach]]></article-title>
<article-title xml:lang="pt"><![CDATA[Manifestação inaugural de seminoma testicular como hemorragia digestiva: uma causa rara de metastização gástrica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Maria Azevedo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Leal]]></surname>
<given-names><![CDATA[Carina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruge]]></surname>
<given-names><![CDATA[André]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernandes]]></surname>
<given-names><![CDATA[Alexandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cunha]]></surname>
<given-names><![CDATA[Maria Fernanda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vasconcelos]]></surname>
<given-names><![CDATA[Helena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar de Leiria Department of Gastroenterology ]]></institution>
<addr-line><![CDATA[Leiria ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro Hospitalar de Leiria Department of Pathology ]]></institution>
<addr-line><![CDATA[Leiria ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>08</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>08</month>
<year>2023</year>
</pub-date>
<volume>30</volume>
<numero>4</numero>
<fpage>59</fpage>
<lpage>63</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452023000400059&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452023000400059&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452023000400059&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Gastric metastases are quite infrequent. When arising from testicular germ cell tumors, gastric metastases are usually associated with nonseminomas.  Case Report:  A 45-year-old man presented with upper gastrointestinal bleeding, severe anemia, and elevated lactate dehydrogenase. Endoscopy revealed three atypical-looking gastric ulcers. Abdominal computed tomography showed an extensive heterogeneous retroperitoneal mass and a smaller one in the pelvis. Biopsies of both the ulcers and the retroperitoneal mass revealed a highly proliferative neoplasia of unknown origin. While the diagnostic work up was taking place, the patient complained of a testicular mass which was resected, after suspicious findings in the ultrasound. Histopathologic findings revealed a testicular seminoma. Revision of previous biopsies was compatible with metastatic seminoma to the stomach and the retroperitoneum.  Discussion/Conclusion:  Gastric metastasis arising from testicular seminoma is quite infrequent and usually diagnosed after the primary tumor is known. We report a rare case of a testicular seminoma presenting as upper gastrointestinal bleeding due to gastric metastases. This case highlights the importance of detailed anamnesis and physical examination in the differential diagnosis of atypical gastric ulcers with initial inconclusive work up and emphasizes an unusual manifestation of a germ cell malignancy.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  As metástases gástricas são bastante infrequentes. Quando são secundárias a tumores testiculares, geralmente as metástases gástricas associam-se a não-seminomas.  Caso Clínico:  Um homem de 45 anos recorreu ao serviço de urgência por quadro de hemorragia digestiva alta, tendo-se detetado uma anemia grave e elevação da lactato desidrogenase. A endoscopia revelou três úlceras gástricas de aspeto atípico. A tomografia computorizada abdominal mostrou uma extensa massa heterogénea retroperitoneal e outra de menores dimensões na cavidade pélvica. Foram realizadas biópsias das úlceras gástricas e da massa retroperitoneal, sendo compatíveis com uma neoplasia altamente proliferativa de origem indeterminada. Durante a investigação etiológica, o doente referiu a deteção de uma massa testicular. Esta foi ressecada após a realização de ecografia com achados suspeitos. A histologia fez o diagnóstico de um seminoma testicular. A revisão das biópsias prévias foi compatível com metastização gástrica e retroperitoneal do seminoma.  Discussão/Conclusão:  A metastização gástrica com origem em seminomas do testículo é infrequente e geralmente é detetada após o diagnóstico do tumor primário. Apresenta-se um caso raro de manifestação inaugural de um seminoma testicular como hemorragia digestiva alta devido a metástases gástricas. Este caso evidencia a importância de uma anamnese e um exame objetivo detalhados no diagnóstico diferencial de úlceras gástricas atípicas com investigação inicial negativa, salientando também uma manifestação infrequente de uma neoplasia de células germinativas.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Testicular seminoma]]></kwd>
<kwd lng="en"><![CDATA[Gastric metastases]]></kwd>
<kwd lng="en"><![CDATA[Gastrointestinal bleeding]]></kwd>
<kwd lng="pt"><![CDATA[Seminoma testicular]]></kwd>
<kwd lng="pt"><![CDATA[Metastização gástrica]]></kwd>
<kwd lng="pt"><![CDATA[Hemorragia digestiva]]></kwd>
</kwd-group>
</article-meta>
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