Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a painless, firm, non-transilluminating testicular mass. Associated symptoms include scrotal heaviness, dull ache, or acute pain if hemorrhage/infarction occurred. Review of systems negative for constitutional symptoms (weight loss, night sweats) or metastatic symptoms (back pain, cough, dyspnea). No history of cryptorchidism or prior testicular malignancy.
Clinical Examination Findings
Genitourinary exam reveals a firm, irregular, non-tender mass within the testicular parenchyma. Scrotal ultrasound confirms a heterogeneous, hypoechoic lesion with internal vascularity and microcalcifications. Abdominal/pelvic exam for lymphadenopathy and supraclavicular/cervical lymph node palpation performed to assess for metastatic spread.
Treatment Protocol
Primary management involves radical inguinal orchiectomy with high ligation of the spermatic cord. Post-operative staging via serum tumor markers (AFP, beta-hCG, LDH) and CT chest/abdomen/pelvis. Adjuvant therapy (chemotherapy or RPLND) determined based on histopathological subtype, lymphovascular invasion, and clinical stage.