Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a palpable, firm, non-tender testicular mass. History significant for potential endocrine manifestations, including gynecomastia, decreased libido, or erectile dysfunction due to hormonal secretion (estrogen/testosterone). No history of trauma or acute inflammatory symptoms.
Clinical Examination Findings
Physical examination reveals a solid, unilateral testicular nodule. Scrotal ultrasound demonstrates a hypoechoic, hypervascularized intratesticular lesion. Systemic exam notes absence of lymphadenopathy; check for secondary sexual characteristics, specifically gynecomastia, indicating hormonal activity.
Treatment Protocol
Recommended management is radical inguinal orchiectomy. Post-operative surveillance protocol includes serial serum tumor markers (AFP, beta-hCG, LDH) and testosterone/estradiol levels. Imaging follow-up with abdominal/pelvic CT scan to monitor for retroperitoneal lymphadenopathy.