Testicular seminoma with metastases

Case contributed by Dr Prashant Mudgal

Presentation

Middle aged patient presented with gradually enlarging scrotal swelling.

Patient Data

Age: 40 years
Gender: Male
Ultrasound

Right testis is enlarged and shows altered echotexture. There is an ill defined hypoechoic mass arising in the upper half of the testis.

The right testis is enlarged and showing a hypodense heterogeneously enhancing mass.

Liver shows multiple, large, round and lobulated hypodense and gradually enhancing masses suggestive of metastatic lesions. The lesion also invading the main portal vein and hepatic IVC resulting in obstruction. There are also few collateral channels can be seen at the level of hilum.

There is a large, conglomerate retroperitoneal lymph nodal mass with cystic necrotic areas within and heterogeneous enhancement noted in the paraaortic region. The lymph nodal mass is encasing the aorta and its branches mainly  superior mesenteric and right renal arteries.

Case Discussion

Seminoma is the most common primary testicular tumour that occurs in males between age of 25 to 45 years. The most common presenting feature is being the painless enlargement of testis and majority of patients present with retroperitoneal lymph nodal metastasis appears as a large paraortic mass which encases the aorta and its branches. 

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Case information

rID: 30689
Case created: 28th Aug 2014
Last edited: 13th Mar 2016
Inclusion in quiz mode: Included

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