CASE HISTORY

The patient was a man of good physique, male with respect to voice, hair and libido, but with undescended testes and hypospadias. In 1937 (age21) a painful lump in the left groin, believed to be the testis, was removed at another hospital. Within the next 3-5 years he developed a feminine fat distribution and breasts of female dimensions. In 1945 (aged 29) the breasts were removed (S45/1050-hyperplastic ducts) and the right inguinal hernia repaired. A biopsy from a nodule in the right inguinal canal showed an indeterminate epithelial structure probably rete testis (S/45/1136). An attempt to repair the hypospadias was made, and failed, but in 1947 was more successful. In January 1950 he reported with right iliac fossa pain and loss of weight for six months duration. A mass was felt and on 20.1.1950. A large, firm, smooth tumour resembling a grossly enlarged testis was seen arising out of the pelvis, attached to the region of the right internal abdominal ring by a broad vascular pedicle. Para-aortic lymph- nodes were enlarged. The mass was removed and the patient made a good recovery. He was given x-rays and at the time of writing this note (6 months after operation) is still quite fit. The Friedman test was negative.

PATHOLOGY

A rounded tumour 155 x 75mm of very typical seminoma type, with the characteristic general resemblance in colour and texture to testis tissue, with thickened tunica albuginea still recognizable over most of its surface; a large nodule extends upwards, however, out of the capsule.