Michael C. Kearney, Robert J. Bae, M.D.,
Adam S. Kibel, M.D.1
Julia R. Fielding, M.D.2
Jerome P. Richie, M.D.1
Department of Urology1
Department of Radiology2
Brigham and Women's Hospital
Harvard Medical School
Boston, Massachusetts

A twenty five year-old man presented with severe right lower quadrant pain of several hours duration. He denied fever, nausea, urinary symptoms or any change in bowel habit. He related having a one year history of malaise, decreased libido, back pain, and twenty pound weight loss.

PMH/PSH: None

Medications: None

Physical Examination:

  1. Large right lower quadrant mass.
  2. Hard right testicular mass.

Laboratory Values:

  1. WBC: 18,000 mm3
  2. alpha-fetoprotein: 56,000 ng/ml
  3. beta-HCG: 18,802 ng/ml

CT

DIAGNOSIS and DISCUSSION

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