Presentation
A testicular mass
Patient Data
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.