| Physical Exam |
07/21/XX |
31 year old male with painless progressive enlargement of L testicle. No GI or GU symptoms. Exam showed large L testicular mass firm and suspicious for malignancy. Remainder of exam normal. Family history positive for father with testicular cancer in his 30s. |
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| X-Rays & Scans |
07/22/XX |
Scrotal sonography: marked enlargement and decreased attenuation of L testis, c/w malignancy. |
| 07/22/XX |
CT chest/abd/pelvis: Two enlarged retroperitoneal nodes (2cm) seen, suspicious for metastasis. |
| 08/04/XX |
PET scan: subtle increased activity anterior to the lumbar spine correlating with lymph node involvement seen on CT. Increased activity is also seen along the course of the L spermatic cord. |
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| Laboratory Reports |
07/23/XX |
AFP = 2.7 (< 9.0 ng/ml). B-hCG = <2 (< 5 mIU/ml). LDH 134 (100-200 U/L). Chart notes tumor markers all unremarkable. |
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| Pathological Reports |
07/23/XX |
L orchiectomy: seminoma 5 cm. No extracapsular extension seen. Intralymphatic tumor in proximal spermatic cord sections. No tumor seen in spermatic margin of resection. |
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| Treatment |
07/23/XX |
Surgery: L radical orchiectomy. |
| 08/24/XX |
Radiation: Beam radiation started to pelvis plus periaortic nodes and involved lymph nodes. |
