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A case of synchronous bilateral testicular seminoma

Nature Clinical Practice Urology volume 5, pages 397–401 (2008)Cite this article

Abstract

Background A previously healthy 51-year-old man with two children sustained a minor testicular trauma and subsequently sought medical care for persistent discomfort.

Investigations Physical examination, scrotal ultrasonography, Doppler ultrasound evaluation of testicular blood flow, scrotal MRI, measurement of serum tumor markers and testosterone levels, CT of the chest, abdomen and pelvis, intraoperative frozen section analysis and final pathologic analysis.

Diagnosis Bilateral testicular seminoma (clinical stage I).

Management The patient initially underwent radical left orchiectomy with intraoperative frozen section analysis, which returned equivocal results. Final pathologic analysis revealed a 2.5 cm left testicular seminoma without vascular invasion. After careful discussion, he ultimately underwent radical right orchiectomy; pathologic analysis revealed a 2.7 cm right seminoma with vascular invasion. Testosterone replacement therapy was initiated. After further discussion, the patient elected to undergo adjuvant abdominal radiotherapy to a total of 25 Gy. The patient showed no evidence of disease over a post-treatment follow-up period of 24 months.

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Acknowledgements

Charles P Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. MJ Resnick is a second-year Resident in Urology, D Canter is a fourth-year Resident in Urology, BM Brucker is a third-year Resident in Urology, and A Kutikov is a Chief Resident in Urology at the University of Pennsylvania Medical Center, Philadelphia, PA, USA.,

    Matthew J Resnick, Daniel Canter, Benjamin M Brucker & Alexander Kutikov

  2. TJ Guzzo is a Fellow in Urologic Oncology at the Johns Hopkins Medical Center, Baltimore, MD, USA.,

    Thomas J Guzzo

  3. AJ Wein is Chief of Urology at the Hospital of the University of Pennsylvania, Philadelphia, PA, USA.,

    Alan J Wein

Authors
  1. Matthew J Resnick
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  2. Daniel Canter
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  3. Benjamin M Brucker
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  4. Alexander Kutikov
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  5. Thomas J Guzzo
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Correspondence to Matthew J Resnick.

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The authors declare no competing financial interests.

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Resnick, M., Canter, D., Brucker, B. et al. A case of synchronous bilateral testicular seminoma. Nat Rev Urol 5, 397–401 (2008). https://doi.org/10.1038/ncpuro1133

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