| A 23-year-old male underwent surgery on two occasions during childhood for hypospadias with a correct evolution and comfortable voiding. | |
| He came to the urologist due to left groin pain and increased size of the left testicle of several weeks of evolution. | |
| On examination, a left testicle was found to be completely enlarged, irregular and indurated, suggestive of testicular tumor with rest of normal examination. | |
| Testicular ultrasound is performed which is described as a cystic nodule with fine septa and a granuloma with intratesticular calcifications and outside the testicle at the lower pole level another cyst with multiple echoes inside or discard epidermoid cyst. | |
| Tumor markers alpha fetoprotein and BHCG were within normal parameters. | |
| The CT scan requested during the patient's admission showed a solid left retroperitoneal tumor at the lateroaortic and prerenal renal hilium of 54x51x90 mm in diameter. | |
| 1. | |
| A left inguinal orchiectomy was performed with pathological result of pure undifferentiated mature teratoma limited to testicle without vascular invasion affecting tunica albuginea but not vaginal size 3 mm without involvement of rectivis. | |
| The patient is admitted to our hospital for evaluation of adjuvant treatment. | |
| We found a nonseminomatous testicular tumor stage pT2 N3, M0 according to the TNM classification and stage II c without poor prognostic factors. | |
| In this situation two options are proposed, starting with chemotherapy and considering resection if residual mass persisted or performing a retroperitoneal lymphadenectomy. | |
| Given the negativity of tumor markers and the pathological anatomy of the testicle and the known chemoresistance of pure mature teratoma it was decided to perform retroperitoneal lymphadenectomy for the possibility of being curative with other primary tumor components. | |
| Retroperitoneal lymphadenectomy was performed to the iliac vessels obtaining the specimen observed in Figure 2. | |
| The anatomopathological result was pure mature teratoma with components of the three embryonic layers without lymphovascular invasion. | |
| The patient is currently under surveillance in consultation with periodic markers, abdominal CT and chest X-ray. | |