A 25-year-old patient who, during admission to the Internal Medicine Department due to a 3-day history of evening fever, was incidentally discovered by ultrasound examination a tumor in the right testicle.
As a personal history, she reported no drug allergies.
Bilateral inguinal hernia repair.
She suffered a painless tumor of one year of evolution that progressively increased.
Physical examination revealed enlargement of the right testicle with painless tumor in the upper pole.
The suspicion of testicular tumor is made different complementary tests.
Testicular ultrasound showed a heterogeneous tumor in the right testicle of 78 mm x 57 mm x 61 mm, solid compatible with primary testicular tumor.
Normal left test.
Computed tomography (CT): right testicular tumour with retrocaval and paraaortic adenopathies > 2 and < 5 cm. Lactate dehydrogenase (LDH): cortropine 5190 IU/ml
He underwent right inguinal orchiectomy with Pathological Anatomy Report of Carma Embrionario of 7 cm that substitutes parenchyma and epididymis with implants in cord and reaches albug.
She was diagnosed with embryonal carcinoma of the right testicle T3N2M0, stage II with intermediate risk by elevation of LDH, completed treatment with chemotherapy according to the BEP scheme (bleom<icina, e)
At 4 years of age, and being free of disease in the follow-up reviews, she came to the emergency room for painful tumor in the left testicle.
Physical examination revealed a left monorchium indurated tumor at the lower pole of the left epididymis.
Among the complementary examinations stands out: Lactate dehydrogenase (LDH): 347 IU/I; alphafetoprotein (AFP): 2.4 ng/ml; beta-gonadotropin alfa mIU/ml.
Chest X-ray: No pathological findings.
Testicular ultrasound: Testicular tumor of 51x19x22 mm in size, with heterogeneous echostructure and color Doppler flow, which also affects the body and tail of epididymis.
Calcification in anteroinferior testicle slope.
Axial Computerized Axial Computerized Axial Axial Axial Axial-Assisted Axial Axial Axial Acidosis - pelvis: Normal liver, spleen and pancreas.
Kidneys with normal morphology and density
No lymphadenopathies or lymph node chains.
Under the suspicion of a second germ cell tumor, left orchiectomy was performed via inguinal approach, resulting from the Pathological Anatomy of classic Seminoma 3.2 cm wide and radical testicular chordoma extending as testicular epididyma
The postoperative course was uneventful.
The patient was referred for evaluation of adjuvant treatment and control.
Since the maximum tumor diameter is 3.2 cm and does not affect the rete testis, conservative control treatment is chosen.
Three months later, in Computerized Control Axial Tomography, an enlarged left retroperitoneal adenopathy (3.5 cm) was detected, with poorly separated blood cell count with psoas that traverses the middle third of the hydroprotein.
Retroperitoneal recurrence is diagnosed and treated with chemotherapy (etoposide and 4-cycle cisplatin).
Currently, the patient has been free of disease for 3 years in the regular check-ups performed in the Urology and Ongoing Services.
