A 25-year-old man, with no personal history of interest, consulted for a tumour in both testicles of two weeks' evolution.
Physical examination: Hard mass occupying more than half of the left testicle. Right testicle increased in consistency, especially in the posterior part.
Complementary examinations:
- Scrotal ultrasound: Solid tumour measuring 37x21 mm, hypoechoic in the right testicle. Two solid lesions in the left teste measuring 32x17 mm and 7 mm with similar ultrasound characteristics to those found in the right teste. All compatible with bilateral multicentric testicular neoplasia. Left varicocele.

- Tumour markers: AFP: normal; ß-HCG: 6.15 mIU/ml (normal value: < 2.5 mIU/ml); LDH: normal.
Surgical treatment: bilateral radical orchiectomy via the inguinal route. The patient ruled out the possibility of prosthesis placement.
Histological diagnosis: seminoma with high mitotic index and vascular invasion (pT2) in both testicles (anaplastic seminoma).

Extension study (thoracoabdomino-pelvic CT): adenopathic growths at retroperitoneal level (N2) and hepatic metastatic lesions (M1).
Complementary treatment: systemic chemotherapy with etoposide and cisplatin (4 cycles).
Currently, after 24 months of follow-up, there are negative tumour markers with absence of retroperitoneal adenopathies and liver metastases (complete remission).
The patient declined the possibility of semen freezing prior to radical surgery.