A 25-year-old male with no personal history of interest consulted for a tumor in both tests of two weeks duration.
Physical location: Hard mass occupying more than half of the left testicle.
Right test increased consistency especially in its posterior part.
Investigations:
Echocardiography : Solid tumor of 37x21 mm, hypoechoic in right test.
Two solid lesions in left test of 32x17 mm and 7 mm of sonographic characteristics similar to those found in the right test.
All this was compatible with bilateral multicentric testicular neoplasia.
Left varicocele.
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- tumour markers: AFP: normal; ß-HCG: 6.15 mIU/ml (normal value: < 2.5 mIU/ml); LDH: normal.
Surgical treatment: Bilateral radical inguinal orchiectomy.
The patient refused the possibility of stenting.
Histological diagnosis : seminoma with high mitotic index and vascular invasion (pT2) in both tests (anaplastic seminoma).
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Extension study (CTC: non-pelvic adenocarcinoma) at retroperitoneal level (N2) and metastatic liver lesions (M1).
Treatment: systemic chemotherapy with tapering and cisplatin (4 cycles).
Currently, after 24 months of follow-up, there is negativization of tumor markers with absence of retroperitoneal lymph nodes and liver metastases (complete remission).
The patient declined the possibility of freezing semen prior to radical surgery.
