A 19-year-old patient, with no history of interest, consulted for a slightly painful tumor in the right testicle of about 8 months of evolution, finding in the clinical examination a testicular enlargement with nodular areas.
The left testicle showed no alterations.
Alpha-Feto-Protein: 38.2 and Beta-HGC: 1.48.
Sonographically, three well-defined, independent tumor nodules are observed: two of them heterogeneous, solid, 20 and 33 mm in diameter, with cystic areas and calcifications.
The third nodule was solid hypoechoic and homogeneous, 26 mm in diameter.
All nodules presented increased vascularization with low resistance arterial flows.
The extension study was negative.
Orchiectomy is performed.
Histologically, the first two nodules corresponded to teratocarcinomas (mature teratocarcinoma and predominant embryonal carcinoma), macroscopically calcified brown-white masses, with cavities of necrosis content and foci of necrosis.
The third was diagnosed as classic seminoma, being more macroscopically homogeneous.
