New Pt into the clinic to establish care (PCP), age 60. PMH: | Figure 1

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New Pt into the clinic to establish care (PCP), age 60. PMH: #Ankylosing-spondylitis, CVA, Hypothyroidism, PTSD, #Depression/anxiety, & "neurogenic bladder"-long term foley. Hx of Gender Reassignment Procedure but didn't disclose on intake. Found in medical records instead. What approach is needed to provide comprehensive care for this pt? Psych issues, trust/identity concerns plus primary care needs. Preventative screenings (PSA)? Advice please. No judgements. Identifies as She. I want to ensure she gets proper care.

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• 18 years old cerebral palsy male Pt presented with retractile strangulated left testes with history of 3 days, just did left #Orchiectomy of the Pt.

• 33 years old man presented with solid mass in the left scrotum, painless, no tenderness with U/S.

• 16-year-old boy case report concerning synchronous bilateral testicular germ cell tumors (BTGCTs).

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.
2. Clinical Findings and Diagnosis: The patient presented with right testicular induration. Scrotal ultrasound showed bilateral testicular nodules with increased vascularity and microlithiasis.
3. Treatment and Results: A bilateral orchiectomy with intraoperative biopsy was performed. Histopathology confirmed bilateral seminoma, stage I, with no metastasis.
4. Discussion and Recommendations: Bilateral seminoma in pediatric patients is extremely rare. Early detection through ultrasound remains critical for high-risk patients.

Ultrasound images of the right testis show a nonseminomatous germ cell tumor (arrow) of the lower poly. Nonseminomatous germ cell tumors are the most common primary testicular malignancy and typically occur in men in the late second to the third decade of life.