A 37-year-old man with no relevant personal or urological history came to our emergency department with pain and inflammation of the left testicle.
She reported progressive left testicular inflammation of two months duration.
He did not complain of fever, urological symptoms, or malaise.
Painful fixation showed an indurated left testicle with a normal epididymis.
The right testicle had normal size and consistency.
Testicular ultrasound showed a large nodular lesion in the left testicle, with a mixed pattern of cystic areas and areas with fine echogenic content, and bilateral testicular solid nodular lesions in testicles.
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Tumor markers showed elevated α-FTP (48.4 ng/mL), normal β-HCG (<0.6 mIU/mL) and normal LDH levels.
No pathological findings of interest were found in TAC-abdominopelvic.
The patient was referred to the fertility section for seminal cryopreservation.
Subsequently, left inguinal orchiectomy with high cord ligation was performed, and right testicular biopsy via inguinal approach, previous clamping of the right cord was performed by orchiectomy was informed, intraoperatively, as positive for inguinal malignant cells.
The pathological study was reported as: left testicle: tumor of 5 cm in diameter with cystic areas, which corresponds to a mixed germ cell tumor formed in similar proportions by mature embryonal carcinoma and teratoma with immature elements.
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Right testicle: a 2.5 cm-diameter grey tumor, which corresponds to a classic seminoma, observing images of intratubular neoplasia, without involvement of the albuginea or epididymis.
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Adjuvant chemotherapeutic treatment was administered with the modified BEP scheme (x2 cycles), later presenting negative markers: α-FTP (3.7 ng/mL), β-HCG (<0.6 mIU/mL) and normal LDH.
Currently, 10 months after the initial diagnosis of bilateral testicular tumor in stage I, the patient is asymptomatic, with negative tumor markers, normal studies and hormonal treatment with testosterone periodic controls.
