The wife of a 35-year old man noted a small induration in his left testicle. Initially he did not do anything, but continued to palpate himself almost every day and concluded that the nodule was growing. Finally after six weeks, his wife persuaded him to visit a doctor. On physical examination, the doctor confirmed the existence of a testicular mass, which could not be transilluminated and appeared to be solid and homogeneous on ultrasound examination. An orchidectomy was performed.

Gross appearance of a bisected testicle. Describe the tumor.

In contrast to seminoma, this tumor does not appear homogeneous. What accounts for the variegated appearance of this embryonal carcinoma?

This slide illustrates the cross section of a teratocarcinoma. Could one suspect this diagnosis on the basis of the gross findings?

Not all tumor nodules in the testis are primary testicular neoplasms. This slide illustrates a renal cell carcinoma metastatic to the testis.

Scheme summarizing the possible histologic progression of germ cell tumors.

Question for Class Discussion