Metastatic mixed germ cell tumor of testis

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

GP referral. Right testicular pain. Cause?

Patient Data

Age: 45 years
Gender: Male

Well defined irregular 2cm solid mass with avid Doppler flow in the lower pole of the right testis.

No hydrocele.

Normal left testis.

Round 3 cm necrotic aortocaval lymph node.

2 cm heterogeneous mass in the lower pole of the right testis.

No solid organ metastases.

Serum tumor markers were undertaken after the ultrasound report:

  • LDH:  221 u/L
  • AFP:  520.9 ng/Ml
  • hCG: 1766.0 IU/L

All elevated.

Case Discussion

A case of metastatic testicular germ cell tumor. A right orchiectomy was performed. The histological report for the specimen was of a mixed non-seminomatous germ cell tumor.

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