A Patient with Testicular Seminoma, Inguinal Lymphadenopathy and Abnormal Pet Scan

Abstract

A 43 year old gentleman presented with a three week history of painless right testicular swelling. He denied any systemic symptoms and was otherwise well. Testicular ultrasound revealed a solid right epididymal mass, concerning for malignancy. Tumour markers (including human chorionic gonadotrophin, alpha fetoprotein and lactate dehydrogenase) were normal. A staging CT scan revealed pathological right external iliac and right inguinal lymphadenopathy. A positron emission tomography (PET) scan showed a flurodeoxyglucose (FDG)-avid right external iliac lymph node, two FDG-avid lymph nodes in the inguinal region, the largest measuring 2.1 cm, and an FDG-avid left inguinal lymph node. There were no other pelvic nodes seen. Figure 1:-Post operative staging PET scan. (A) 3 cm FDG-avid right external iliac lymph node (B) Two FDG-avid lymph nodes in the right inguinal region, the largest measuring at 2.1 cm (C) 1.8 cm FDG-avid left inguinal lymph node