Presentation
Gradually worsening right testicular pain for five months.
Patient Data
A large heterogeneous lobulated hypoechoic mass measuring about 1.9 x 3.4 cm is seen in the right testis. The mass is invading the tunica albuginea posteriorly and has multiple tiny internal calcifications. The mass is hyper vascular on color Doppler ultrasound examination. Small right hydrocele. Left testis is normal.
Enlarged necrotic left supra and infra clavicular lymph nodes; supraclavicular lymph node measures 1.4 x 2.6 cm and infraclavicular lymph node measures 1.5 x 1.8 cm. Enlarged necrotic pre-aortic, para-aortic, aortocaval and retrocaval lymph nodes at the level of renal hilum; the largest retrocaval lymph node measures 1.7 x 2.7 cm and the largest aortocaval node measures 2.3 x 2.3 cm. Multiple small mesenteric lymph nodes. No mediastinal lymphadenopathy is seen. No abdominal visceral, pulmonary or osseous abnormality is seen. Post-surgical changes of right inguinal orchiectomy are noted, Right testicular prosthesis seen in place.
Histopathology shows embryonal cell carcinoma measuring 3 cm and invading the tunica vaginalis and tunica albuginea.
Case Discussion
Ultrasound shows malignant looking right testicular mass invading the tunica albuginea.
Histopathology shows embryonal cell carcinoma measuring 3 cm and invading the tunica vaginalis and tunica albuginea.
CT scan shows multiple abdominal necrotic lymph nodes along with a few necrotic left supra and infra clavicular lymph nodes.
Laboratory investigations show: B-HCG=24.4 IU/L (0.0-5.0 IU/L), AFP=2.8 ng/ml (≤8ng/ml), LDH=447 U/L (125-220 U/L).
According to the TNM staging of the testicular tumors; final tumor stage is T2N2M1a.
Unable to process the form. Check for errors and try again.