PMC6362783_01
Testicular choriocarcinoma. Preoperative imaging. (a) Scrotal ultrasonography reveals 12.5 cm heterogeneous scrotal mass with central necrosis. (b) Chest X-ray reveals diffuse pulmonary metastases. (c) Magnetic resonance imaging brain reveals a small enhancing lesion
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F1
Scrotal ultrasound revealed a 12.5 cm heterogeneous scrotal mass with central necrosis [Figure 1a]. Chest X-ray revealed diffuse pulmonary metastases [Figure 1b]. Magnetic resonance imaging (MRI) of the brain was ultimately performed for questionable altered mental status and revealed a small enhancing lesion [Figure 1c].
Testicular choriocarcinoma. Pathology/gross specimen. (a) Right testicle, gross. (b) Gross right testicle, incised to reveal large, centrally necrotic lesion. (c) Histopathology reveals complete replacement of parenchyma with tumor and epididymal invasion. (d) Histopathology reveals multinucleated syncytiotrophoblasts. (e) Histopathology reveals tumor emboli
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F2
Gross examination demonstrated a large, centrally necrotic lesion [Figure 2a and b]. Noted on histopathology were a complete replacement of parenchyma with tumor and epididymal invasion [Figure 2c], multinucleated syncytiotrophoblasts [Figure 2d], and tumor emboli [Figure 2e].
Testicular choriocarcinoma. Postoperative Imaging. Computed tomography imaging of the chest reveals left lower lobe pulmonary embolism (arrow)
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F3
CT angiogram was performed to evaluate for pulmonary embolism (PE), which demonstrated a singular, small left lower lobe PE, determined to be an unlikely contributor to his profound hypoxemia [Figure 3].