Presentation
Gradually enlarging scrotal swelling.
Patient Data
The right testis is enlarged and shows altered echotexture. There is an ill-defined hypoechoic mass arising in the upper half of the right testis. Left testis normal.
Multiple lobulated solid metastatic liver lesions. Echogenic thrombus within the main portal vein.
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 tumor 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.