Abstract
M. W., a 42-year-old man, presented with painless enlargement of the left testicle and right lower extremity weakness associated with low back pain. Physical examination revealed a firm mass in the left testicle and right lower extremity weakness associated with decreased sensation corresponding to spinal cord levels L4-S1. Lactic dehydrogenase and p human chorionic gonadotropin were elevated at 478 and 40, respectively, and (Y fetoprotein was normal. Scrotal ultrasound demonstrated a heterogeneous, solid left testiculac mass (fig. 1). Computerized tomography (CT) of the abdomen showed no evidence of retroperitoneal adenopathy. Magnetic resonance imaging of the spine revealed a sacral mass within the epidural space abutting the nerve roots SlS3. Left radical orchiectomy was performed. Pathological FIG. 2. CT guided fine needle aspiration reveals sacral mass evaluation &owed a mixed germ cell t~mor composed of seminoma, mature teratoma and embryonal cell carcinoma. CT guided aspiration of the sacral mass revealed cellular characteristics consistent with seminoma (fig. 2).
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