This is a 40-year-old man of Bulgarian nationality who presents in his personal history gastroesophageal reflux and incompetent cardia, not surgically intervened or previously transfused, of profession used in smoking cigarettes for 15 years.
Family history included mother, father and brother with nephrolithiasis.
He had been seen 21 days before admission due to pain in the right flank radiating to the ipsilateral testicle which was classified as probable renal colic and treated with analgesia, with favorable evolution; subsequently, he began no fever with similar symptoms.
She came back to the emergency room where an abdominal ultrasound was performed, describing the presence of hydronephrosis grade II/IV and a mass in the right reteroperitoneum of about 6-7 cm, for study.
The patient complained of right flank/kidney pain radiating to the ipsilateral test without nausea or vomiting or a thermometered fever.
Examination revealed only positive right renal succupation.
ECG showed sinus rhythm at 76 bpm, chest X-ray showed no significant pathological changes.
Blood tests revealed fibrinogen 478 mg/dL (150-450), SGV21 mm/hour (2-15), urea 52 mg/dL (10-50), creatinine 1.4 mg/dL (0.6-1.2), and human alpha (0.64-1.2), LDH
The inferior vena cava was demarcated with focal adenopelvic lesions, wherein the middle retroperitoneum was described (between the aorta and the inferior vena cava), a single, well-attenuated mass of 5.5 cm was not observed.
Urology consultation was performed urgently performing right nephrostomy.
Ultrasonography-guided trucut biopsy of retroperitoneal mass is performed and the pathological anatomy is sent. It is reported as a neoformation consisting of small non-smooth cells germ cells that are arranged in nests, with small non-smooth cells, small nuclei and small lymphocytic cells with small nuclei; there are small nuclei; there are non-smooth positive nuclei; there are small nuclei; there are small nuclei; there are non-smooth
Other ultrasound tests showed a nodular-ovoid lesion in the right testis, isodense with a hypodense halo of 16 mm, in the upper half and a small testicular nodule of approximately 5 mm compatible with a hyperechoic tumor.
Subsequently, the patient was referred to the Urology Department after consultation with On, to undergo orchiectomy and later undergo chemotherapy cycles in the On-therapy Service.
