Rare Non-germ Cell Testicular Tumors: A Series of Three Cases

Testicular neoplasms are the most common malignancy among men aged 20-40 years. More than 95% are germ cell tumours and 5% are sex cord stromal tumours. The most common presentation is a painless scrotal lump. Sometimes, it may present as a painful lump, mimicking an inflammatory lesion. Case 1, a 3...

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Main Authors: Vilas Pandurang Sabale, Ujjwal Bhardwaj, Deepak Mane, Vikram Satav, Abhirudra Mulay
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2025-06-01
Series:Journal of Clinical and Diagnostic Research
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Online Access:https://jcdr.net/articles/PDF/21057/75131_CE[Ra1]_F(IS)_QC(PS_SS)_PF1_(RI_KR_SS)_PFA(IS)_PN(IS).pdf
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author Vilas Pandurang Sabale
Ujjwal Bhardwaj
Deepak Mane
Vikram Satav
Abhirudra Mulay
author_facet Vilas Pandurang Sabale
Ujjwal Bhardwaj
Deepak Mane
Vikram Satav
Abhirudra Mulay
author_sort Vilas Pandurang Sabale
collection DOAJ
description Testicular neoplasms are the most common malignancy among men aged 20-40 years. More than 95% are germ cell tumours and 5% are sex cord stromal tumours. The most common presentation is a painless scrotal lump. Sometimes, it may present as a painful lump, mimicking an inflammatory lesion. Case 1, a 34-year-old male presented with right testicular pain and a lump for one month, with normal tumour markers. Clinically, it appeared as a testicular malignancy, but with normal tumour markers, it mimicked an inflammatory lesion, creating a management dilemma. A Computed Tomography (CT) scan ruled out retroperitoneal lymph node metastasis. Right high inguinal orchidectomy with frozen section was performed, suggesting malignancy. Immunohistochemistry confirmed leiomyosarcoma. Case 2, an 82-year-old male presented with a painless right testicular lump for one month, with a history of acute urinary retention secondary to benign prostatic enlargement {treated with Transurethral Resection of the Prostate (TURP)}. Clinically, it was a hard lump suggestive of malignancy, confirmed on ultrasound, although tumour markers were normal. A CT scan was negative for lymphadenopathy. Right high inguinal orchidectomy was performed. Histopathological examination showed non-Hodgkin’s lymphoma; the patient subsequently underwent chemotherapy. Case 3, a 29-year-old male complained of right testicular pain. Examination revealed a tender nodule (1×1 cm) on the posterolateral aspect of the right testis, clinically appearing as a firm mass, confirmed on ultrasonography, although tumour markers were misleadingly normal. High inguinal orchidectomy was performed, with histopathological examination positive for intratesticular adenomatoid tumour. High inguinal orchidectomy was the treatment of choice in all three cases, followed by adjuvant chemotherapy or radiotherapy depending on histopathology. Conclusion: Testicular tumours may mimic inflammatory lesions, creating management dilemmas. Thorough clinical examination and investigations are required for planning and management. Normal serum tumour markers and ultrasound cannot rule out malignancy.
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spelling doaj-art-d64ae788537c479e8415a4e39ad8e38e2025-08-20T02:02:13ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-06-01196OR01OR0410.7860/JCDR/2025/75131.21057Rare Non-germ Cell Testicular Tumors: A Series of Three CasesVilas Pandurang Sabale0Ujjwal Bhardwaj1Deepak Mane2Vikram Satav3Abhirudra Mulay4Professor, Department of Urology, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India.Senior Resident, Department of Urology, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India.Professor, Department of Urology, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India.Professor, Department of Urology, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India.Professor, Department of Urology, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India.Testicular neoplasms are the most common malignancy among men aged 20-40 years. More than 95% are germ cell tumours and 5% are sex cord stromal tumours. The most common presentation is a painless scrotal lump. Sometimes, it may present as a painful lump, mimicking an inflammatory lesion. Case 1, a 34-year-old male presented with right testicular pain and a lump for one month, with normal tumour markers. Clinically, it appeared as a testicular malignancy, but with normal tumour markers, it mimicked an inflammatory lesion, creating a management dilemma. A Computed Tomography (CT) scan ruled out retroperitoneal lymph node metastasis. Right high inguinal orchidectomy with frozen section was performed, suggesting malignancy. Immunohistochemistry confirmed leiomyosarcoma. Case 2, an 82-year-old male presented with a painless right testicular lump for one month, with a history of acute urinary retention secondary to benign prostatic enlargement {treated with Transurethral Resection of the Prostate (TURP)}. Clinically, it was a hard lump suggestive of malignancy, confirmed on ultrasound, although tumour markers were normal. A CT scan was negative for lymphadenopathy. Right high inguinal orchidectomy was performed. Histopathological examination showed non-Hodgkin’s lymphoma; the patient subsequently underwent chemotherapy. Case 3, a 29-year-old male complained of right testicular pain. Examination revealed a tender nodule (1×1 cm) on the posterolateral aspect of the right testis, clinically appearing as a firm mass, confirmed on ultrasonography, although tumour markers were misleadingly normal. High inguinal orchidectomy was performed, with histopathological examination positive for intratesticular adenomatoid tumour. High inguinal orchidectomy was the treatment of choice in all three cases, followed by adjuvant chemotherapy or radiotherapy depending on histopathology. Conclusion: Testicular tumours may mimic inflammatory lesions, creating management dilemmas. Thorough clinical examination and investigations are required for planning and management. Normal serum tumour markers and ultrasound cannot rule out malignancy.https://jcdr.net/articles/PDF/21057/75131_CE[Ra1]_F(IS)_QC(PS_SS)_PF1_(RI_KR_SS)_PFA(IS)_PN(IS).pdfadenomatoidleiomyosarcomanon germ cell tumournon-hodgkins lymphoma
spellingShingle Vilas Pandurang Sabale
Ujjwal Bhardwaj
Deepak Mane
Vikram Satav
Abhirudra Mulay
Rare Non-germ Cell Testicular Tumors: A Series of Three Cases
Journal of Clinical and Diagnostic Research
adenomatoid
leiomyosarcoma
non germ cell tumour
non-hodgkins lymphoma
title Rare Non-germ Cell Testicular Tumors: A Series of Three Cases
title_full Rare Non-germ Cell Testicular Tumors: A Series of Three Cases
title_fullStr Rare Non-germ Cell Testicular Tumors: A Series of Three Cases
title_full_unstemmed Rare Non-germ Cell Testicular Tumors: A Series of Three Cases
title_short Rare Non-germ Cell Testicular Tumors: A Series of Three Cases
title_sort rare non germ cell testicular tumors a series of three cases
topic adenomatoid
leiomyosarcoma
non germ cell tumour
non-hodgkins lymphoma
url https://jcdr.net/articles/PDF/21057/75131_CE[Ra1]_F(IS)_QC(PS_SS)_PF1_(RI_KR_SS)_PFA(IS)_PN(IS).pdf
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