A 29-year-old patient is admitted to our service with a painless tumor in his left testicle of one month of evolution without other symptoms.
An ultrasound scan showed a hypogenic left testicle of size that made it difficult to assess, and a heterogeneous right testicle with decreased neoplasm.
She reported no drug allergies and had no personal history of interest.
Physical examination revealed a left hypotrophic test.
The right test is somewhat enlarged.
Both were painless, with normal consistency and regular surface.
No pathological findings were observed.
Tumor markers resulting in an alpha-fetoprotein of 2.7 ng/ml with a beta-hCG of 4.2 mIU/ml were requested.
During admission, new complementary examinations are performed, and Doppler flow ultrasound shows a right test of 49 mm x 36 mm x 26 mm with hypoechoic lesion, with lobulated edges, all heterogeneous, occupying a testicle.
And a left test of 32 mm x 22 mm x 20 mm hetrogenous focal lesion slightly hypoechoic of approximately 9 mm with subtle Doppler flow.
In addition, bilateral testicular microlithiasis.
Contrast enhanced CT scan showed no lymph nodes or metastases in any of the areas visualized.
With the diagnosis of bilateral testicular tumor, bilateral inguinal orchiectomy was performed.
At the same time she began to use hormonal treatment.
Pathological anatomy reports an atrophic left testicle with multiple microscopic foci of classic Seminoma associated with large areas of Intratubular Neoplasia absence of Germline Cells (neglected intravascular testis), with
The right testicle presents a tumor with characteristics of classic Seminoma that occupies almost the entire parenchyma, associated with foci of Intratubular Neoplasia of Germ Cells in the testes (INCG) and foci of
Tunica albuginea, rete testis, epididymis and surgical edge free of tumor.
Treatment was completed with two cycles of chemotherapy with platinum.
It has now been approximately three and a half years free of disease.
