Renal and urinary tract masses Quiz: Ace Your Exams

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A 60-year-old male comes to the physician’s office due to scrotal pain for the past 2 weeks. The patient describes a dull pain and noticed that his scrotum appears larger. He also felt fatigued and hot for the past 2 months and thinks that his vision has become blurrier. Medical history is significant for hypertension and hyperlipidemia. The patient has smoked 1 pack of cigarettes per day for 30 years. Medications include lovastatin and ramipril. The patient’s temperature is 37.7°C (99.9°F), pulse is 80/min, and blood pressure is 145/85 mmHg. Physical examination reveals facial flushing. Examination of the scrotum shows left side swelling which is not reduced when the patient is lying down. When light is applied to the testicle it does not transilluminate. This patient’s underlying condition most likely originated from which of the following areas?  

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