A case of synchronous bilateral testicular seminoma.
BACKGROUND
A previously healthy 51-year-old man with two children sustained a minor testicular trauma and subsequently sought medical care for persistent discomfort.


METHODS
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.


METHODS
Bilateral testicular seminoma (clinical stage I).


RESULTS
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.
Division of Urology, University of Pennsylvania Medical Center, Philadelphia, PA, USA. matthew.resnick@uphs.upenn.edu
Matthew J
MJ
Resnick
Daniel
D
Canter
Benjamin M
BM
Brucker
Alexander
A
Kutikov
Thomas J
TJ
Guzzo
Alan J
AJ
Wein
D000728:Androgens / Q000627:therapeutic use; D002278:Carcinoma in Situ / Q000601:surgery; D005629:Frozen Sections; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D009919:Orchiectomy; D019736:Prostheses and Implants; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D018239:Seminoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D013736:Testicular Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D013737:Testis / Q000000981:diagnostic imaging / Q000293:injuries; D013739:Testosterone / Q000627:therapeutic use; D014463:Ultrasonography
D000728:Androgens; D013739:Testosterone