Testicular tumour - a diagnostic dilemma

A 45 year-old man presented to us with upper abdominal lumps of different sizes with heaviness and mild pain. He underwent two surgeries previously one was right sided orchidectomy through scrolal incision and another one laparatomy which was done four months later of 1st one. But in both situations - no biopsy were taken & failed to establish a diagnosis. On the basis of clinical, bio-chemical and radiological examinations - it was a diagnostic dilemma. Then we performed laparotomy followed by debulking and biopsy was taken for histopathological examination. It revealed metastatic teratoma of testis.