The history corresponds to a 30-year-old male, white, obese, agricultural worker, with a history of having suffered several traumas in the scrotum, being on one occasion admitted five years ago by suffering an exanthema.
Six months ago she began with pain in the left supratesticular level, also noting a slow-growing tumor, which partially improved with the use of medicaments for type Ibuprofen.
The patient notes that in the last month the pain has become more intense and the tumor has grown rapidly and progressively so it is decided his admission.
Physical examination revealed changes in color and slight edema of the upper third of the scrotum, where a well-defined, nodular, encapsulated tumor measuring 5x5x2 cm was found. The tumor had a firm consistency.
Nothing relevant was found in the rest of the physical examination.
Analytical studies that include human chorionic acid beta (b-GCH) and alpha fetoprotein (a-a) were within normal limits, as well as the mediastinum and retroperitoneal CT space.
Testicular ultrasound showed a solid and hyperechoic tumor of 5x5x2 cm in the lower pole of the left testicle, displacing the testicular parenchyma, without the presence of hydrocele, or signs of inflammation.
A testicular surgical exploration was performed, verifying the existence of a nodular lesion in the lower pole of the left testicle of 5x5x3 cm, proceeding to an ovoid, firm, circumscribed and analyzed tumor, adhered.
Microscopically, a neoplasm consisting of tubular spaces lined by flat and cubic cells was observed.
The cytoplasmic vacuolization was evident, finding smooth muscle bands and nodular aggregates of lymphocytes, without mitotic activity.
The immunohistochemical study showed positivity for calretinin, EMA and vimentin, while staining for CEA, CD31 and CD34 were negative in all cells.
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The patient was discharged without alterations and was completely asymptomatic after one year of follow-up.
