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Testicular yolk sac tumor

Case contributed by Alexandra Stanislavsky
Diagnosis certain

Presentation

A testicular mass

Patient Data

Age: 2 years
Gender: Male
ultrasound

The right testis is grossly enlarged and replaced with a heterogeneous, hyperechoic mass with multiple cystic areas within it. The mass contains extensive internal vascularity with some low resistant arterial waveforms.

No inguinal or intra-abdominal lymphadenopathy seen.

Case Discussion

The appearance of a large mass replacing the testes, with cystic (necrotic) areas, but without any tumoral calcification or fat favors the diagnosis of a yolk sac tumor over a teratoma, which is the main differential in this age group.

The patient's serum AFP was elevated, further supporting this diagnosis. 

This was subsequently proven histologically.

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