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case_images: Left scrotal ultrasound image where fluid-filled cystic areas are black foci (arrow) interspersed within the white solid mass.
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case_images: Tumor markers were not raised and scrotal ultrasound revealed a large diffuse heteroechoic mass in the left hemiscrotum, measuring 10.9 x 9.8 x 9.7 cm3 with areas of calcification and cystic change (Figure 1).
case_images: Contrast-enhanced computed tomography of the pelvis showing a large diffuse heterodense mass lesion in the left scrotum with heterogeneous enhancement (arrow) on contrast study.
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case_images: Contrast-enhanced computed tomography (CECT) showed similar findings in the left hemiscrotum with moderate heterogeneous enhancement on contrast study (Figure 2).
case_images: Specimen of the left testis showing a large solid, cystic mass with foci of yellowish discoloration (arrow).
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case_images: Grossly (Figure 3), the specimen of high inguinal orchiectomy weighed 560 g and measured 13 x 9 x 5 cm3.
case_images: Photomicrograph showing diffuse sheets of histiocytes (small arrow) and giant cells (big arrow).
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case_images: Microscopy showed complete replacement of the testicular parenchyma by diffuse sheets of histiocytes and giant cells with areas of old hemorrhage, suggestive of xanthogranulomatous inflammation (Figure 4).
case_images: Necrotic material was identified in cyst contents.
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case_images: A cystic change containing necrotic debris was identified (Figure 5).
case_images: Asteroid bodies (arrow) seen in the cytoplasm of giant cells.
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case_images: Asteroid bodies were noted in the cytoplasm of most of the giant cells (Figure 6).
case_images: The mononuclear as well as giant cells show diffuse and strong immunopositivity for CD68, suggestive of histiocytic origin.
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case_images: The xanthomatous histiocytes and giant cells were immunoreactive for CD68 (Figure 7).