From Gynecomastia to Unexpected Testicular Mass: Clinical Journey of a Young Male with a Mixed Non-Seminomatous Germ Cell Tumor

A 20-year-old male presented to Breast Clinic with asymptomatic, bilateral gynecomastia. Thorough physical examination revealed an incidental finding of an enlarged left testicle. Further investigation led to the diagnosis of testicular cancer without evidence of distant metastasis. The patient underwent radical left orchiectomy. Final pathology revealed Stage IB mixed Non-Seminomatous Germ Cell Tumor (NSGCT) with lymphovascular invasion (pT2). Adjuvantly, he received a single cycle of chemotherapy that was well tolerated. Although the presentation of painless testicular mass was characteristic for a patient with this diagnosis, it ultimately was diagnosed by the surgeon when being evaluated for a chief complaint of gynecomastia. This case highlights the need for vigilance in thorough physical examination and detection of testicular tumors in the primary care setting.