Based on the appearance, what should be the most likely diagnosis?
Such a heterogenous appearance of testicular mass, points to possibility of non-seminomatous germ cell tumour. However, larger seminomas sometimes may look similar.
If you have to choose one tumour marker to differentiate the two, which one you would prefer?
Serum AFP is never elevated in seminomas. It's usually elevated in all NSGCTs (especially yolk sac tumour).
A large heterogeneous solid-cystic mass lesion is seen in the right scrotal sac, and right testis could not be seen separately from the lesion. It shows internal vascularity.