Surgical treatment of testicular tumor and its difficult management with indigenous patient

Case description of a male patient, 27 years old, native Brazilian, indigenous, deaf, with a significant growth of left testicle, painless, with infiltrations, insidious beginning and two years of evolution because of the difficulty of monitoring this type of population. Presented high serum level of lactate dehydrogenase (LDH), up to 20 times higher than the maximum reference value. Ultrasound of the testis showed a complex mass on the left testicle, not being able to give an estimate of the volume. The patient underwent a partial left scrotectomy, associated to radical left orchiectomy, showing an extended invasive testicular tumor and left inguinal lymphadenopathy. Histopathology was compatible with seminoma, weighting 2.600 g, with secondary implants on lungs, retroperitoneum and inguinal region, classified as Stage IIIC. The patient was referred to chemotherapy. Testicular tumor is approached as rare and this is one of the few of its descriptions with such size.