[A case of testicular tumor with a small tumor focus in the testis]

The initial symptom of a testicular tumor is painless enlargement of the testis in most cases, but in some cases can manifest itself with metastatic lesions associated with a small focus. On the other hand, a occult testicular tumor accompanied by a minimal lesion in the testis, may be included in the category of extra gonadal germ-cell tumors. We have seen a 41-year-old male with a chief complaint of swelling of a cervical lymph node, who was found to have a tumor in the testis of normal size. A CT scan revealed a tumor in the retroperitoneal space. The serum levels of HCG and AFP were markedly elevated. Biopsy of the cervical lymph node established a diagnosis of embryonal cell carcinoma. The left testis, free from a palpable mass but tender, was excised. A gonadal cell tumor approximately 7 mm in size was just below the epididymis. A stage III-a testicular tumor was diagnosed in the patient. Three courses of VAB-6 yielded partial relief in the patient. We concluded that the testis should be carefully examined with echogram whenever a extra gonadal germ-cell tumor is suspected, since a tiny lesion can exist in the testis concomitantly in some cases.