Case presentation -Testicular tumor.pptx

Testicular tumors by souparno

1. Case presentation -Testicular tumor Dr Arpan Bera 1 st year PGT( Dept of General Surgery)

2. Patient particularies Name- Mr Shukdeb Samanta Age- 50 years Sex- Male Adress - Sundarban Occupation- Auto driver Religion- Hindu Date of admission- 20/03/23 Date of examination- 27/03/23

3. Chief complaint Swelling in the left scrotum for last 6 months

4. History of presenting illness Patient was apparently well 6 months back when he noticed swelling in left side of scrotum which was incidious in onset; small lemon size initially; gradually increasing in size to attain the present size. There is no alteration in size of swelling during his daily activities. Patient also complained of sensation of heaviness on the same side. No history of trauma No history of any other swelling in any part of body No history pain, generalised weakness , loss of appetite, cough, chest pain.

5. Past history No history of any comorbidities. No past history of major illness.

6. Treatment history Patient was taking homeopathy medication for last 2 months for the illness.

7. Personal History Patient is average built, mixed dietary habit, normal bowel and bladder habit, disturbed sleep for last 2 months.

8. Family History No one in the family suffers from the same disease

9. General survey Patient is alert, conscious, cooperative, Karnofsky’s score- 90 Oriented to time, place and person Average built Nutritional status is good Decubitus of choice Facies- Ill looking no sign of pallor icterus, cyanosis, clubbing, bilateral pedal edema

10. Neck glands- not palpable JVP not raised Facies- ill looking Blood pressure- 130/80 mm of Hg Pulse- 84/min, regular, normal volume, Spo2- 96% at room air RR- 20/ min No obvious deformity in any part of body

11. Local examination- Inspection Inspection done in standing position initially and asked to lie down while eliciting some tests under proper day light after taking consent Skin and subcutaneous tissue of scrotum- Tense , rugosity absent on left side. Swelling- Shape- globular Size-approx 6x4cm Position- left side of scrotum Surface- smooth Skin over the swelling- tense, rugosity absent on left side Position of penis- slightly deviated to right side Cough impulse- absent Nonreducible

12. Palpation Temperature- raised on left side of scrotum Nontender Getting above the swelling is possible Swelling Size- 6x4cm Shape- globular Extend- root of scrotum Surface- smooth Margins- regular Consistency- firm Irreducible Spermatic cord- palpable on both side Right sided testis present in right scrotum

13. Abdominal examination Abdomen is soft, nontender , no obvious swelling present in abdomen, inguinal lymph nodes are not palpable. All hernial orifices are intact.

14. Summary A 50 years old gentlemen presented with a swelling in left scrotum for last 6 months which gradually increasing and attain the present size. There is no alteration in size of swelling during any daily activities. Patient also complaints of feeling of heaviness in left side of scrotum. No history of trauma. O/E- a 6x4cm, globular, firm, nontender , irreducible, swelling present of left side of scrotum. The right testis and spermatic cords of both side are palpable and abdominal examination is normal.

15. Left sided high inguinal Orchidectomy was done.

16. Provisional Diagnosis Left sided testicular swelling probably seminoma ( T1-2N0MX) in a 50 years old male patient