Abstract
Testicular cancer in black subjects is rare with an annual age adjusted incidence of 0.9/100,000 compared to 3.7/ 100,000 for all men. While cryptorchidism is a known risk factor for malignant transformation, the lifetime risk of development and death from testicular cancer declines with age.1 Orchiopexy, orchiectomy and observation are accepted forms of management for an undescended testis depending on patient age at presentation. Orchiopexy is primarily recommended before puberty while orchiectomy is recommended after puberty. However, for men older than 32 years the incidence of testicular cancer declines, and it has been recommended that this age group should only be observed periodically.' We report a case of an aggressive germ cell tumor of rare pathology in a black man treated with cryptorchidism after observation failed. CASE REPORT A 51-year-old morbidly obese black man presented with a 1-year history of an enlarging right scrota1 mass. Medical history was notable for a right inguinal testicle with a normal ultrasound examination performed 8 years before presentation. Lactic dehydrogenase, a-fetoprotein and P-human chorionic gonadotropin were within normal limits. Ultrasound
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