First description of an orthotopically located spontaneously ruptured non-seminomatous, metastatic germ cell tumor and review of literature.

Spontaneous rupture of a testicular tumour is extremely rare. We report a 51-year-old man presenting with rapid, painless scrotal swelling without trauma. Imaging showed a ruptured left testicular mass with extensive hematoma, emergency exploration confirmed tumour perforation. Histology revealed a yolk sac-predominant non-seminomatous germ cell tumour. While initial staging was negative, early restaging before adjuvant therapy identified a new pulmonary metastasis. The patient received three cycles of BEP chemotherapy and achieved complete remission. He remains disease-free at two-year follow-up. This case emphasises prompt evaluation and early restaging in atypical acute scrotal presentations.