A 29-year-old man without a past medical history presents with abdominal pain and left testicular swelling for the past few months. Scrotal ultrasound demonstrated a mildly enlarged heterogeneous-appearing left testicle. Computed tomography (CT) was performed. Lactate dehydrogenase was 2454 U/L, beta-human chorionic gonadotropin was 517 mIU/mL, and alpha-fetoprotein was 8.5 ng/mL. A left radical orchiectomy was performed, with final pathology showing pure embryonal carcinoma invading the spermatic cord. The patient was diagnosed with stage pT3cN3M1b testicular cancer.
CT scan is shown below*: