It's Soft, Non-tender Mass Quiz Time with Med-Challenger!
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A 21-year-old male presents to your office for a routine physical exam. He has no significant medical history and has no complaints. He had no major childhood illnesses, but states that he did have an orchiopexy at a very young age for a case of cryptorchidism.
He denies smoking, alcohol, or illicit drug use. He says he is sexually active with 1 partner. He has no known allergies, and he is not currently taking any medications except for a natural protein powder supplement.
On physical exam his temperature is 98.6o F; blood pressure is 118/72 mm Hg; pulse is 64/minute, and respirations are 14/minute. His cardiovascular, respiratory, and abdominal exams are unremarkable. Upon examination of the genitalia for a possible hernia, a soft, non-tender mass is felt on the posterior aspect of the left testicle.
Labs are drawn, and the patient is told to return in 1 week to discuss the results. Patient’s labs showed a normal basic metabolic panel, normal complete blood count, and a normal urinalysis. Levels of serum beta-human chorionic gonadotropin were increased, but alpha-fetoprotein levels were within normal limits. The additional metastatic workup findings were negative.
Ultrasound of the testicles showed the following:
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What is the most likely diagnosis?
This question appears in Med-Challenger Family Medicine Exam Review with CME
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