Retroperitoneal lymph node metastasis from testicular tumor hidden by vena cava transposition

We herein report a case of a retroperitoneal lymph node metastasis from a malignant teratoma with yolk-sac admixtures originating from the right testicle. The metastasis was missed on CT scanning due to a vena cava crossing over with the aorta in the region of the metastatic disease, but typical tumor marker elevation was seen on follow-up.