Routine Drug Screening Leads To Unusual Diagnosis

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Routine Drug Screening Leads To Unusual Diagnosis - Page #3

Lab Studies: Labs were obtained within 48 hours of the patient presentation. His hCG was 4 IU/L, which was similar to the original level obtained three months prior. The alpha-fetoprotein (AFP) level was 10 ng/mL. The complete blood count and comprehensive metabolic panel were within normal limits. Other Studies: An ultrasound of the scrotum was obtained the next day. This exam demonstrated multiple small hypoechoic masses in the left testicle measuring 1.5 cm, 1.8 cm, and 1.1 cm, suspicious for malignancy. Normal appearing right testicle. There was appropriate bilateral testicular arterial and venous blood flow. A CT chest was obtained within a week and demonstrated no evidence of metastatic disease. CT of the abdomen and pelvis revealed a mildly prominent lymph node adjacent to the left gonadal vein superiorly, measuring 1.3 by 1.4 cm. There was no other lymphadenopathy. Case Photo #1 Consultations: The patient was referred to urology and oncology. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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