Exam (elaborations)
Ihuman Case: A Man in His Twenties with a Testicular Mass
- Course
- Institution
Ihuman Case: A Man in His Twenties with a Testicular Mass
[Show more]
Content preview
Ihuman Case: A Man in His Twenties with a Testicular MassGenitourinary Pathology
Contributed by Jacob Jerome, MD and Sheldon Bastacky, MD
Clinical History
A male in his 20s presented with low back and left testicular pain. On physical exam, his left
testicle was markedly enlarged and a discrete mass was palpated. CT of the abdomen and pelvis
demonstrated a 19 cm left testicular mass, 14 cm conglomerate retroperitoneal lymphadenopathy
with obstruction of the left ureter, and bilateral basilar pulmonary metastases. At this time, his
serum lactate dehydrogenase (LDH) was 741 IU/L, alpha-fetoprotein (AFP) was 31,861 ng/mL,
and β-human chorionic gonadotropin (β-hCG) was 29,789 mIU/mL.
Gross Examination
The left radical orchiectomy specimen measured 19.8 x 9.2 x 8.9 cm (Figure 1A), with the mass
measuring 19.6 x 9.2 x 8.9 cm and grossly appearing to involve the epididymis, rete testis,
spermatic cord, and paratesticular soft tissue. The cut surface of the mass (Figure 1B) was
heterogenous and variegated with areas that were tan-white and rubbery, brown and necrotic,
cystic, myxoid, and hemorrhagic.
P a g e 1 | 13
, Figure 1.
Microscopic Examination
The tumor was heterogenous with multiple components. The majority of the tumor
(approximately 85%) was composed of clear to palely eosinophilic tumor cells with vacuolated
cytoplasm and mild nuclear atypia in a predominantly microcystic and reticular growth pattern
(Figure 2A). Scattered endodermal sinus growth pattern demonstrating Schiller-Duval bodies
was also present (Figure 2B). This tumor component was also present as a discrete nodule
adjacent to the proximal spermatic cord, representing either a tumor-replaced lymph node or soft
P a g e 2 | 13
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller TutorExpert. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $22.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75632 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now