Metastatic testicular teratoma

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Presented with a left testicular lump and left loin/flank pain.

Patient Data

Age: 30 years
Gender: Male
ultrasound

Diffuse microlithiasis with a well defined hetergenous mass in the inferior pole.   (Sub-optimal image quality -ICB)

3.3cm right upper lobe lung mass with adjacent satellite nodules.

Huge partially necrotic left para-aortic lymph node mass, abutting the aortic and displacing the left renal vessels anteriorly.

pathology

Specimen from a left orchiectomy - open and cut gross histopathological samples.

The well defined mass contains internal hemorrhage, and correlates with the ultrasound appearances.

Case Discussion

Testicular malignancies have a bimodal distribution of both the young and elderly.

A controversial relationship exists between testicular microlithiasis and predisposition to malignancy.

Testicular tumors commonly metastases to the lungs and draining lymph nodes - as in this case along the course of the left testicular vein to the para-aortic regions.

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