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A 40 year-old man presented with a one month history of night-sweats, fatigue, dyspnea on exertion and a 35 pound weight loss. There was a four-year history of abdominal discomfort. The abdomen was mildly tender diffusely with no mass palpable. The lower extremities were slightly edematous with numerous varicosities. CT scan revealed a large (9X8cm) heterogeneously enhancing retroperitoneal mass (see retroperitoneal germ cell tumor, part 1 and part 2, metastatic testicular germ cell tumor, and non-seminomatous germ cell tumor) at the level of the kidneys encompassing the right renal artery and involved the inferior vena cava ith a filling defect. The mass invades the right psoas muscle and extends down to the common iliac veins.
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Careful reexamination revealed a right testicular mass, seen here on a low CT cut. Alphafetoprotein was 3.6 (normal < 20 ng/ml), HCG was 831 (normal < 5 microunits/ml).
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Venogram showed blockage of the inferior vena cava with collateral flow through lumbar veins and body wall collaterals.
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This page was last modified on 8/12/2008.
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