Primary Squamous Cell Carcinoma of the Testis

A 64-year-old man had a history of an enlarged left testis for years with painful swelling 2 months in duration. Ultrasonography revealed a mixed pattern echogenic intratesticular tumor. Carcinoembryonic antigen level was 3.18 ng./ml. (normal less than 1.5) and other laboratory evaluations were unremarkable. Left radical orchiectomy was performed. The testis appeared irregular and firm. After bisection, a thick walled 5 x 3 x 3 cm. cyst was noted with cheesy content confined within the tunica albuginea. On microscopy the cystic wall was lined with squamous cell carcinoma (fig. 1). The cystic cavity was filled with laminated keratin. A focal benign-looking squamous lining was identified (fig. 2). A small rim of compressed hyalinized seminiferous tubules surrounded the cyst peripherally. Thorough evaluation revealed no evidence of teratomatous elements or intratubular germ cell neoplasia and retrospective surveys of other organs