--- a
+++ b/data/text/es-S0004-06142008000600014-1.txt
@@ -0,0 +1,16 @@
+A 37-year-old man, with no personal or urological history of interest, who came to our surgery referred from the emergency department for pain and swelling of the left testicle.
+He referred a picture of progressive left testicular swelling of two months' evolution. He reported no fever, no accompanying urological symptoms, and no general malaise.
+On palpation, the left testicle was indurated and slightly painful, with a normal epididymis. The right testicle was normal in size and consistency.
+Testicular ultrasound showed a large nodular lesion in the left testicle, with a mixed pattern of cystic areas and areas with fine echogenic content, and solid nodular lesions in the right testicle, findings related to bilateral testicular neoplasia.
+
+Tumour markers showed elevated α-FTP (48.4 ng/mL), normal β-HCG (<0.6 mIU/mL) and normal LDH.
+No pathological findings of interest were found in the thoraco-abdominal-pelvic CT scan.
+The patient was referred to the fertility department for seminal cryopreservation. Subsequently, a left inguinal orchiectomy was performed with high cord ligation, and a right testicular biopsy via the inguinal route, after clamping the spermatic cord, which was reported intraoperatively as positive for malignant germ cells, so the surgery was completed with a right inguinal orchiectomy.
+The anatomopathological study was reported as follows: Left testicle: tumour 5 cm in diameter with cystic areas, corresponding to a mixed germinal tumour formed in similar proportions by adult embryonal carcinoma and teratoma with both mature and immature elements, which does not exceed the albuginea.
+
+Right testicle: greyish tumour 2.5 cm in diameter, corresponding to seminoma of the classic variety, with images of intratubular neoplasia, without involvement of the albuginea, epididymis or spermatic cord.
+
+Adjuvant chemotherapy treatment was administered with the modified BEP scheme (x2 cycles), subsequently presenting negative markers: α-FTP (3.7 ng/mL), β-HCG (<0.6 mIU/mL) and normal LDH.
+Currently, 10 months after the initial diagnosis of stage I bilateral testicular tumour, the patient is asymptomatic, with negative tumour markers, normal radiological studies and on hormone replacement therapy with periodic controls of testosterone levels.
+
+