Case Study - March 2011

A 72 year old man presented to his GP with a one week history of a painless left testicular lump found on self examination.

  1. What do the ultrasound images show?
  2. What are the differential diagnosis of testicular lesions in this age group?
  3. What investigations are needed?
  4. What is the first treatment step for each of the differential diagnoses?

Reveal Answer

Open answer There is no fixed answer to this question, however your response should be similar to the one below:

  1. Bilateral testicular lesions.
  2. Lymphoma, seminoma, benign testicular lesions.
  3. A CT of the chest, abdomen and pelvis and tumour markers (alpha-fetoprotein, beta-HCG and LDH). These tests were normal so the patient went on to have a testicular biospsy.
  4. For malignant lesions, the patient requires bilateral orchidectomy.

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