The patient was initially treated with antibiotics by his primary care physician but groin fullness and swelling persisted.

Testicular ultrasound showed multiple intratesticular masses consistent with malignancy. CT of chest, abdomen and pelvis done prior to inguinal orchiectomy revealed retroperitoneal lymphadenopathy most consistent with metastases from his testicular cancer. Serum tumor markers showed normal AFP and beta-hCG and elevated LDH.