A 14-year-old male patient, previously asymptomatic, living in Medellin, is referred to the Urology Department of the Hospital Pablo Tobón Uribe with a diagnosis of left testicular mass.
The patient incidentally presented a painless testicular mass in left and left area, without noticeable growth of this mass over time, unrelated to local trauma or associated with other symptoms.
Located at first to the physician of his place and ordered an echographic study which showed in the left sac two rounded patterns, well-defined images of similar size, shape and echogenicity x 11
This study ruled out lesions in the epididymis.
With this result they suggest ruling out testicular mass or supernumerary testicle and refer it to the internist physician, who orders a nuclear magnetic resonance (NMR), which reported the presence of three well-defined adenopathy or sacs with aspect
For these findings they refer him to urology.
Patient with negative personal history.
On physical examination the patient was in good general condition, with vital signs within normal parameters for age and adequate pondoestural development; in the abdomen he did not have palpable masses or inguinal hernias.
In the external genitalia, a normal penis was observed, and there were no painful signs of healthy testicles and an adenomatous spherical mass located in the upper area (proximal) of the left hemiscrotum.
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On the basis of the clinical history, studies and findings on physical examination make a diagnostic impression of paratesticular mass or PQ.
With this clinical approach and previous review of the subject it was decided to carry out surgery for exploration and resection of this lesion, prior informed consent of the patient and his family.
Under general anesthesia, we performed an epiprecision only in transverse position, with posterior dissection up to the albuginea on the left side, observing the presence of two structures of equal size, aspect and proximal consistency with testicles.
Section, ligation with exhaustive hemostasis and section of the latter were performed; a rounded carmelite structure of firm consistency of approximately 1.2 cm in its largest diameter was obtained for pathological study.
A pocket is made in a sub-data space where the healthy testicle is lodged. It is fixed with polygyne Johnson & Johnson Vicryl® 4-0 (absorbable suture material).
Flat closure was performed and left ilioinguinal nerve block was performed.
She was discharged in the immediate postoperative period and evolved satisfactorily without complications.
Two fragments are used for pathology report and a normal testicle is reported in histological sections.
No intratubular seminal neoplasia.
