29-year-old male patient.
Choledocholithiasis is a congenital malformation of the right parotid gland, after a painless tumor appearing in the left testicle of one month of evolution, an ultrasound detected a hypogenic left testicle with decreased size
No other urological symptoms, no asthenia, no weight loss.
She has no personal history of interest.
Physical examination revealed a hypotrophic left test and a somewhat enlarged right test.
Both were painless, with normal consistency and regular surface.
No pathological findings were observed.
Analytical determinations include hemostasis, biochemistry and hemogram within normal parameters, and an alpha-fetoprotein of 2.7ng/ml with a beta-hCG of 4.2mIU/ml.
During admission, a new Doppler flow ultrasound was performed, showing a right test of 49 mm x 36 mm x 26 mm with hypoechoic lesion of lobulated edges, heterogeneous, occupying almost the entire testicle.
And a left test of 32mm x 22mm x 20mm hetrogenous focal lesion slightly hypoechoic of approximately 9mm with subtle Doppler flow.
In addition, bilateral testicular microlithiasis.
A chest X-ray was also performed, in which no pathological finding was observed, and a CAT scan showed metastases with non-pelvic contrast, in which neither lymphadenopathy nor visual metastases were identified.
With the diagnosis of bilateral testicular tumor, a bilateral inguinal orchiectomy was performed and the patient was treated with a hormonal contraceptive.
Pathology reports: atrophic left testicle with multiple microscopic foci of classic seminoma associated with large areas of intratubular neoplasia of germ cells (NICG) with absence of testis or indivisceral epi, in cancer.
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 (testicular) and rest of focus GCN.
Tunica albuginea, rete testis, epididymis and surgical edge free of tumor.
Treatment was completed with two cycles of chemotherapy with platinum according to the hospital protocol.
Currently she has more than three years in complete remission of the disease.
