Presentation
Presented with a left testicular lump and left loin/flank pain.
Patient Data
Diffuse microlithiasis with a well defined hetergenous mass in the inferior pole. (Sub-optimal image quality -ICB)
3.3cm right upper lobe lung mass with adjacent satellite nodules.
Huge partially necrotic left para-aortic lymph node mass, abutting the aortic and displacing the left renal vessels anteriorly.
Specimen from a left orchiectomy - open and cut gross histopathological samples.
The well defined mass contains internal hemorrhage, and correlates with the ultrasound appearances.
Case Discussion
Testicular malignancies have a bimodal distribution of both the young and elderly.
A controversial relationship exists between testicular microlithiasis and predisposition to malignancy.
Testicular tumors commonly metastases to the lungs and draining lymph nodes - as in this case along the course of the left testicular vein to the para-aortic regions.