Case Discussion

Case DiscussionRight Seminoma Testicular CancerPatient IdentityNameMr. J KAge41 yoSexMaleAddressJl. S Supriyadi RT 2/2 Sukun MalangNo. Medical Record112021859OccupationArmy soldierCourse of The DiseaseSuffered from right solid testicular enlargement with intermittent pain 1,5 years agoRight radical orchidectomy by Urologist at RST were done, with pathological result was seminomaSuffered from left solid abdominal mass 8 months ago, getting larger and painful. Non visualized in right kidney, right hydronephrosis Gr II , susp right proximal ureteral stone and abdominal masses were found from radiological examination. Patient then referred to RSSAIn 24th Oct 2014 right ureterorenoscopy were done by Urologist at RSSA. Right ureteral obstruction and moderate hydronephrosis caused by abdominal mass were found, Double J stent insertion were done.Patient referred to Medical Oncologist, and received chemotherapy with 4 cycles BEP (4 November 2014- 6 Januari 2015)From abdominal CT scan, no abdominal mass was found.Right DJ stent removal were done by Urologist at RSSA %th March 2015

Physical Examination13 October 2014 25 February 2014 General Examination

Compos Mentis GCS 456BP : 120/70PR : 80x/mntRR : 18x/mntCompos Mentis GCS 456BP : 120/70PR : 80x/mntRR : 18x/mntUrological Examination

Costo Vertebra Angle Tenderness D

Palpable solid mass in left hemi abdomen S, 12 cmx12cm, mobile, tenderness

Scar gibson incision reg inguinal D 7cm

Scrotum : testis D -, testis S intact,

DRE : within normal limitCosto Vertebra Angle Tenderness -

Reg. abd : Mass -

Scar gibson incision reg inguinal D 7cm

Scrotum : testis D -, testis S intact,

DRE : within normal limitLaboratory Examination13 October 2014 25 February 2014 Hb : 14.3 g/dlLeucocyte : 6 .93 103/L Thrombocyte : 350. 103 /L Ur : 23.70 mg/dLCr : 1.9 mg/dL

Hb : 10.90 g/dlLeucocyte : 1.7 .103/L Thrombocyte : 56. 103 /L SGOT : 23 U/LSGPT : 19 U/LUr : 29.20 mg/dLCr : 1.65 mg/dL

AFP: 15.97 ng/mLHCG: 4.54 ng/mLLDH: 1687 ng/mLAFP: 5.52 ng/mLHCG: 0.16 ng/mLLDH: 273 ng/mLRadiological ExaminationIVP ( Sept 2014 )

Post Right URS + DJ Stent Insertion

BOF + USGAbdominal CT

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