Date of Presentation:4/26/2021

Attending pathologist: Anil Parwani, MD, PhD

Presented by: Marlon Szczepaniak, BS

Prepared by: Marlon Szczepaniak, BS



A 56 y/o male during workup for an original presentation of alcoholic cirrhosis and lymphadenopathy, had also presented with enlarged lymph nodes in the retrocrural and para-aortic regions. Following a PET scan revealing retroperitoneal and para-aortic lymphadenopathy, a retroperitoneal lymph node biopsy was performed to find a minute cluster of malignant cells with unknown origin. A CT was performed, revealing a vague slightly hypoechoic polylobulated lesion on the inferior aspect of the left testicle measuring 1.2 x 1.7 x 1.0 cm. Denied having any testicular complaints.


The specimen is designated "left orchiectomy" and consists of a 39.0 gram left orchiectomy specimen. The testis measures 4.0 x 1.8 x 1.7 cm. The spermatic cord measures 8.0 x 1.7 cm. The specimen is bivalved to reveal a firm, tan, centrally located mass that measures 1.8 x 1.3 x 1.1 cm. The mass measures greater than 5 cm from the spermatic cord margin. The mass does not grossly involve the tunica albuginea, hilar fat, rete testis, or epididymis. The remaining testicular parenchyma is tan-white, pallor, and strings with ease.

What is the most likely diagnosis?

  1. Sarcoidosis
  2. Non-Hodgkin's B-cell Lymphoma
  3. Metastatic Seminoma
  4. Leydig Cell Tumor
Metastatic Seminoma