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Testicular seminoma

Case contributed by Abdallah Al Khateeb
Diagnosis certain

Presentation

Painless right testicular enlargement over a year.

Patient Data

Age: 30 years
Gender: Male
ultrasound

Well-defined, bilobed, heterogeneously hypoechoic right testicular mass with internal vasularity. No calcifications. No extratesticular extension.

Normal left testicle.

Case Discussion

For this previously healthy young patient with a painless vascular unilateral testicular mass, the differential considerations are fairly limited.

While the differential diagnosis of a "unilateral testicular mass" includes many non-neoplastic and neoplastic etiologies, primary neoplasia remains the most common and important etiology.

Seminoma typically presents as a homogeneous hypoechoic hypovascular mass. Larger seminomas, as in this case, may be heterogeneous and hypervascular.

Right orchiectomy and pathology confirmed seminoma.

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