Heterogeneous mixed echogenicity left testicular mass lesion likely representing a non seminomatous germ cell tumor, which was later proven to be a mixed germ cell tumor.

Laboratory investigations showed normal tumor markers {AFP= 2.9 ng/ml (normal: ~8), Beta-HCG=2.9 IU/L (normal: 0-5), LDH=210 U/L (normal: 125-220)}. 

Staging workup showed left para-aortic lymphadenopathy. After left inguinal orchiectomy, the patient was referred to the medical oncologist for further management.