Testicular and scrotal conditions Quiz: Ace Your Exams
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A 61-year-old man comes to the office for evaluation of right-sided scrotal fullness of several weeks duration. The patient describes a dull, achy pain in his scrotum when standing for prolonged periods of time. He has noticed a 4.1-kg (9-lb) weight loss over the past three months and intermittent blood in his urine. Past medical history is significant for hypertension. He has a 45-pack-year smoking history. Vitals are within normal limits. Physical examination reveals temporal wasting and diffuse loss of muscle tone. Scrotal examination reveals a right-sided mass that feels like a “bag of worms” and does not decompress in the recumbent position. The left testicle is unremarkable. The scrotum does not transilluminate. Right-sided flank pain is reproduced with palpation. Which of the following is the most likely etiology of this patient’s clinical condition?
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