Mixed germ cell tumor. Testis | Figure 1

Mixed germ cell tumor. Testis

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Ultrasound of the scrotum shows innumerable testicular microlithiasis. Testicular microlithiasis represents intratubular calcifications. This case is an extreme example of the findings. In most cases, this is considered a benign finding. There is some controversy as to whether patients with testicular microlithiasis have an increased risk of testicular malignancy. #TummyTuesday

33 years old man presented with solid mass in the left scrotum ,painless no tenderness with U/S shows homogeneous mass adhere to the left testis , open orchictomy was decided through inguinal inscion , and we remove the mass which was infected multiple septated hydrocele

28 years old man with history of shortness of breath for 2 mounths. He complains of abdominal and testis pain in recent year that subsided with the pain killer.

See more on my case report: pubmed.ncbi.nlm.nih.gov/

1. Background and Case Overview: Synchronous bilateral testicular germ cell tumors (BTGCTs) are very rare in pediatric patients. Cryptorchidism significantly increases the risk of testicular cancer, making early diagnosis essential. This study presents a case of a 16-year-old boy with a history of bilateral cryptorchidism and orchidopexy, who developed bilateral seminoma.
2. Clinical Findings and Diagnosis: The patient presented with right testicular induration. Physical examination revealed Tanner stage 3 genitalia and full induration of the right testicle, but no mass in the left. Scrotal ultrasound showed bilateral testicular nodules with increased vascularity and microlithiasis, raising suspicion for germ cell tumors.
3. Treatment and Results: A bilateral orchiectomy with intraoperative biopsy was performed. Histopathology confirmed bilateral seminoma, stage I, with no metastasis. Follow-up tumor markers and imaging were normal.
4. Discussion and Recommendations: Bilateral seminoma in pediatric patients is extremely rare, especially when synchronous. Cryptorchidism remains a key risk factor, emphasizing the need for long-term monitoring. Diagnosis relies on clinical exam, imaging, and biopsy. Treatment often involves orchiectomy, impacting hormonal and fertility functions. Given the rarity, a multidisciplinary approach is essential, including fertility preservation and hormonal follow-up. Early detection through ultrasound remains critical for high-risk patients.