Mixed Germ Cell Tumour of the Testis Clinical History A 21-year old male presented with a 3-week history of increased swelling in the left hemiscrotum. The patient was referred urgently to urology. An ultrasound of the scrotum was requested as an initial diagnostic approach. Case Description Ultrasound performed, using a 15 MHz linear transducer, revealed 7.5 cm heterogeneous mass occupying the entire left hemiscrotum. The mass showed strong evidence of internal vascularity on power Doppler imaging (PDI). Diagnosis/ Discussion/ Treatment/ Follow up The tumour markers (HCG, AFP, and LDH) were significantly raised, further confirming the ultrasound findings. CT scan of the chest, abdomen and pelvis with contrast was performed to adequately stage the disease. The patient had radical left orchiectomy and histology analysis of the tumour samples confirmed a diagnosis of a mixed germ cell testicular tumour (50 % yolk sac and 50 % embryonal carcinoma). Sonograms B-mode of the left testicular mass next to the normal right testis CDI comparing the vascularity of the testes Left testicular mass with measurement callipers in longitudinal and axial views PDI of the left testicular mass showing some internal vascularity Axial CT showing the left testicular mass Keywords Testicular cancer, Yolk sac carcinoma, Embryonal carcinoma Published on: November 25, 2024
