A 14-year-old male patient, with no morbid history, presented with low intensity trauma (pelotazo) in the genital area.
On physical examination, the patient complained of pain, which made difficult the fixation, with an asymmetric increase in left testicular volume, without other associated lesions.
An echotomography was requested, presenting control after 5 months, clinically verifying an indurated mass in the left testicle approximately 2 cm in diameter, non-painful and with no major testicular alteration or compromise without right testicle.
Ultrasonography showed a well-defined 18 x 19 x 15 mm nodule of hyperechogenic walls with posterior acoustic shadow test in the left pedicle thickness.
The right testicle, epididymis and cords and sperm not present alterations in their echostructure.
Serological study for tumor markers (α-fetoprotein and hormone cortisol sub-unit β) were normal.
Computed tomography (CT) of the pelvis, abdomen and chest showed no secondary lesions.
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Tumor enucleation and intraoperative biopsy were performed.
A fragment of 5 g testicle of 35 x 17 x 15 mm was examined on the cut surface of a lesion presenting thickened, well-defined, thickened areas with solid consistency of 22 mm.
The histological section by morphologic congelation showed periphery lymphout lesion with nests and cords formed by oval cells polygons of large nuclei, abundant infiltrated central eosinophilic and aggregated central lymphocytes, predominantly inflammatory region.
The stroma is hyaline with areas of myxoid degeneration and abundant calcifications arranged at interstitial level and lumen of tumor nests, including calcified parts of contemporary biopsy a tumor.
There was no intratubular tumor extension, mitotic figures, necrosis, marked cytological atypia or extratesticular tumor extension.
Immunohistochemical study showed intense positivity for α-inhibine, S-100 and vimentin, with a low proliferation index (Ki-67) (< 1%).
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Surgery was completed with radical orchiectomy.
There were no postoperative complications.
Eight months after surgery, the patient was healthy, with no evidence of disease on chest-abdomen and pelvis CT; the association with CaregJ complex and Peutz syndrome was ruled out in this patient.
