PMC5926249_01
Computed tomography scan at the first visit. (A, B, C) Contrast-enhanced images of lymph node metastases. (D, E) Primary tumor of the right testis and spermatic cord. Only plain images were available. The arrows indicate the tumors.
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Imaging studies revealed a right testicular tumor with left supraclavicular, mediastinal, and retroperitoneal lymph node swelling (Fig. 1).
Post-chemotherapy 2-18fluoro-deoxy-d-glucose positron emission tomography (FDG-PET) images. (A) Maximum intensity projection (MIP) image, (B) MIP-fused image, and (C, D) fused PET-CT images. The arrows show two 10-mm right inguinal FDG-positive nodules.
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The FDG-PET showed positive nodules in the right inguinal region near the proximal stump of the right spermatic cord (Fig. 2).
Post-chemotherapy diffusion-weighted whole-body magnetic resonance imaging with background suppression (DWIBS) images. (A) Maximum intensity projection (MIP) image, and (B, C) T2-diffusion fused images. The arrows show there is no significant positive intensity in the right inguinal lesion. DWIBS was performed with a 1.5-T MR system (Ingenia, Philips Healthcare, Best, the Netherlands) with a b-value of 1000 s/mm2.
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However, DWIBS performed at the same time revealed no residual disease in his body (Fig. 3).
Histopathological findings. (A) Surgical specimen 65 x 50 x 8 mm in size. (B) Several granulomas are scattered in the excised specimen (hematoxylin and eosin staining, 100 x ). The granulomas contained fragmented surgical threads, but no residual seminoma.
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Pathological examination of the specimen revealed granulomas caused by silk surgical threads, without viable cancer (Fig. 4).