Delayed Presentation of Testicular Seminoma with Normal Biomarkers: A Case Report and Review

Seminoma is a prominent subtype of testicular cancer, which is the most prevalent solid tumor in young adult males, for the best patient outcome, where early diagnosis and management are crucial. Here we describe a male patient, age 22, who had an RT-sided gradual onset painless scrotal swelling for the last six months. On examination, a hard, well-defined intratesticular mass was felt, which proved to be highly vascular on imaging. Alpha-fetoprotein and β-HCG were within normal range. The provisional diagnosis of seminoma was made, which was confirmed by a histopathological exam, where radical inguinal orchiectomy was performed. The current case emphasizes that although its malignant seminoma produces minimal symptoms, the tumor markers are within normal limits, which adds to the diagnostic challenges. It is important to keep in mind that prompt imaging and surgical management are necessary to achieve better patient outcomes, regardless of normal lab tests. A normal lab test does not exclude malignancy, and the malignant potential has to be kept in mind in the young age group.