A 29-year-old white male patient initially presented with a left solid testicular mass found on self-examination. Per the patient, it is painless and has enlarged over a several month period. He has a remote history of a left undescended testicle and orchiopexy at age 6 years. The patient’s tumor markers (AFP, ß-HCG, LDH) were within normal limits. He underwent a staging computed tomography scan that revealed no evidence of metastatic disease.

After extensive discussion he elected to proceed with a left radical inguinal orchiectomy for definitive management. His pathology was consistent with a stage IB, pT2NxMx, seminoma of the left testicle.

Figure 1. A scrotal ultrasound (4/3/2019) scan revealed a 4.6 × 3.4 × 5.8cm solid heterogeneous mass in the left testicle that is suspicious for a primary testicular malignancy.

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