Contributed by Melissa B. Halpern, MD, Jason C. Fowler, and Uma Rao, MD
Published on line in April 1999
The patient is an eighteen year old male with painless enlargement of the right testes over a period of several months, initially attributed to a sports injury. Serum alpha feto-protein (AFP) was 20,927, beta-human chorionic gonadotropin (b-HCG) 49,525, lactate dehydrogenase (LD) 859. CT scans of the chest, abdomen and pelvis revealed pulmonary nodules, mediastinal lymphadenopathy, multiple hypodense lesions of the liver, and multiple right retroperitoneal lesions. Family history is significant for a paternal uncle diagnosed with a testicular carcinoma in his 20's.