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Testicular CA DDX: STEVH

D: Testicular CA. DDX: varicocele, spermatocele, hydrocele, epididymitis, testicular torsion
C: non-transiluminating, non-tender mass, supraclavicular Virchow node
N: Radial Orchiectomy then search for metastatic disease
M: seminoma (1/2) vs nonseminomatous 
R: XY gonadal dysgenesis, androgen insensitivity
C: supraclavicular Virchow node, below average fertility before treatment
T: Radical Orchiectomy - testis, epididymis, spermatic cord taken at the internal iliac ring

Seminoma is exquisitely sensitive to radiation and chemo (when bulky and advanced) and is thus tx differently from other testicular tumors.
Lifetime cancer incidence is remaining testicle is increased manyfold.
Non-transilluminating testicular mass in a young man is testicular ca until proven otherwise.
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