Dr. Zuzana Kos
Resident PGY4

Case Two


Clinical history: This 23-year-old gentleman was found to have a palpable right testicular mass picked up by his family doctor. Ultrasound at that time was able to identify a hyperechoic solid nodule in the lower pole the right testis. Further workup including a chest x-ray and CT of the abdomen did not show any metastatic disease. Tumour markers including LDH, beta-hCG and AFP were normal. On exam, palpation of the right testis identified a mildly tender mass in the lower pole of the right testis that was quite firm in nature and adherent to the testis itself. The patient underwent orchiectomy.

The following slides represent the lesion:

What is in the differential?
How must this lesion be sampled?
In this case, the entire lesion looked like the representative slides. What is the diagnosis?

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