Testicular Tumors

A 28-year-old man presents with a painless left testicular mass noticed 3 months ago. He denies trauma, fever, or systemic symptoms. On examination, the left testis is firm, enlarged, and non-transilluminable. Serum AFP is 450 ng/mL (normal <10), β-hCG is normal, and LDH is mildly elevated. Ultrasound confirms a 4 cm heterogeneous mass within the testis. What is the most likely histological diagnosis?

A 35-year-old man from Mumbai presents with a 2-month history of left testicular swelling and a dull ache. On examination, the left testis is firm, enlarged (5 cm), and the spermatic cord is thickened. Serum AFP is normal, β-hCG is 850 mIU/mL (normal <5), and LDH is 600 IU/L. Chest X-ray shows bilateral hilar lymphadenopathy. Inguinal ultrasound confirms a heterogeneous testicular mass with no free fluid. What is the most appropriate next step in management?

Which tumor marker is most sensitive for detecting yolk sac tumor (endodermal sinus tumor) of the testis?

A 32-year-old man presents with a 2-month history of left testicular swelling and a dull ache in the left lower abdomen. On examination, the left testis is firm and enlarged; the scrotum does not transilluminate. Serum AFP is 8 ng/mL (normal <10) and β-hCG is 2 mIU/mL (normal <5). Scrotal ultrasound shows a 3.5 cm homogeneous hypoechoic mass confined to the testis. CT abdomen/pelvis reveals a 2 cm left para-aortic lymph node. What is the most likely diagnosis and the appropriate next step in management?

A 28-year-old man presents with a 3-week history of painless left testicular swelling. On examination, the left testis is firm, enlarged, and does not transilluminate. There is no history of trauma or infection. Serum AFP is 450 ng/mL (normal <10) and β-hCG is 8 mIU/mL (normal <5). Scrotal ultrasound shows a 4 cm hypoechoic mass within the testis with increased vascularity on Doppler. What is the most likely diagnosis?