"Red herrings," adolescents, and testicular tumors

Testicular tumors, although rare in the general population, comprise the most common class of solid tumors in males aged 15-34 years. Although commonly appearing as a painless scrotal mass, one-third of testicular tumor cases are accompanied by pain or other atypical symptoms that may confound diagnosis, particularly if the clinician is misdirected by other issues. In this case report of an adolescent male with embryonal cell carcinoma of the right testis, a premorbid history of psychological problems, and immature, complaining behavior led to an improper assessment of the significant clues in the patient's oral history and a delay in diagnosis.