TESTICULAR tumors commonly appear as a painless enlargement of the testis accompanied by a feeling of scrotal heaviness or pain. However, in 4% to 14% of patients with malignant testicular disease, the first manifestations are those resulting from metastatic deposits.1 In most of these patients, physical examination of the testicles shows an obvious tumor, but in a small group, no primary tumor can be detected even by repeated examinations.
Rudnick and Odell2 reported the case of a young man with excessive serum gonadotropin levels, but an extensive search, including surgical exploration of both testes, failed to disclose a malignant neoplasm. The patient died one year later, and at autopsy, the primary tumor was found in the left testis. These authors proposed that in the absence of signs or symptoms suggesting a neoplasm elsewhere, the most likely site of a gonadotropin-producing neoplasm in a man is the testes, one
Lee YN, Gold RH. Localization of Occult Testicular Tumor With Scrotal Thermography. JAMA. 1976;236(17):1975–1976. doi:10.1001/jama.1976.03270180051023
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