This case involves a forty-two-year-old male patient who presented to his primary care physician with complaints of a mass in his right testicle. The PCP sent the patient for an ultrasound that was interpreted as normal and had no signs of any acute scrotal abnormality. The patient was started on antibiotics for what was suspected to be epididymitis. The patient waited two weeks for the medication to exert its effects and, in that time, the mass doubled in size. The PCP sent the patient to a urologist who read the original radiology report, but it recently had an addendum added that stated the patient had a 1.8 x 1.6 ill-defined mass like lesion present in the right testicle. The urologist performed an additional ultrasound and ran blood work that revealed the patient had an HCG marker for testicular cancer that was at a level of 4200. The patient’s follow-up ultrasound was highly suggestive of cancer and the patient underwent an orchiectomy procedure the following day.
Question(s) For Expert Witness
Should this malignancy have been ruled out during the first visit?
Expert Witness Response E-000029
Yes, more testing should have been done on the initial visit with a patient that presents with a testicular mass. The normal workup of patients with suspected testicular cancer includes a complete history and physical examination. Blood should be obtained for a chemistry profile including lactate dehydrogenase (LDH), complete blood count, serum tumor markers including alpha fetoprotein (AFP), and the beta subunit of human chorionic gonadotropin (beta-hCG).
About the author
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Michael Talve stands at the forefront of legal innovation as the CEO and Managing Director of Expert Institute. Under his leadership, the Expert Institute has established itself as a vital player in the legal technology arena, revolutionizing how lawyers connect with world-class experts and access advanced legal technology. Michael's role involves not only steering the company's strategic direction but also ensuring the delivery of unparalleled intelligence and cutting-edge solutions to legal professionals. His work at Expert Institute has been instrumental in enhancing the capabilities of attorneys in case preparation and execution, making a significant impact on the legal industry's approach to expert consultation and technological integration. Michael's vision and execution have positioned the Expert Institute as a key facilitator in the intersection of law and technology.
