REASON
CHIEF COMPLAINT: History of stage IIC pure seminoma status post four cycles of etoposide and cisplatin.
HISTORY OF PRESENT ILLNESS
Mr. Sandoval is a very pleasant 22-year-old gentleman who presents to the oncology clinic for stage IIC pure seminoma status post four cycles of etoposide and cisplatin. The patient presented in 09/2016 with a 10-month history of enlarging right testicular mass and pain. In 09/14/2016, he was sent for ultrasound which revealed a 6.8 x 5.5 x 5.5 cm right testicular mass. Ultrasound also showed a retroperitoneal mass that measures 6.8 x 5.9 x 7 cm between the aorta and left kidney. The left testicle was normal. On 09/23/2016, he underwent a CT scan which showed extensive retroperitoneal lymphadenopathy with dominant left periaortic lymph nodes with a mass extending into the level of the left renal artery which was partially encased down to the aortoiliac bifurcation. The mass measured 8.3 x 7.1 cm. The mass abutted and appeared to be partially encased in the left renal vein which was displaced anteriorly. Alpha-fetoprotein was 5.4, and beta HCG was 11.2, and LDH was 484. The patient subsequently, underwent a right radical orchiectomy without complication on …show more content…
Generally, this is a well-developed man sitting comfortably in no acute distress. Skin is warm and dry. HEENT: Head is normocephalic and atraumatic. Pupils are equal and reactive to light and accommodation. Sclerae are anicteric. Oral mucosa is moist without lesions. No JVD. No thyromegaly. Lymphatics: No cervical, supraclavicular, axillary, or inguinal adenopathy is appreciated. Respiratory: Lungs are clear to auscultation bilaterally. Heart: Regular rate and rhythm. Abdomen: Soft and nontender. Positive bowel sounds. Liver and spleen not palpable. Strength is 5/5 throughout. Neurological exam is
CHIEF COMPLAINT: History of stage IIC pure seminoma status post four cycles of etoposide and cisplatin.
HISTORY OF PRESENT ILLNESS
Mr. Sandoval is a very pleasant 22-year-old gentleman who presents to the oncology clinic for stage IIC pure seminoma status post four cycles of etoposide and cisplatin. The patient presented in 09/2016 with a 10-month history of enlarging right testicular mass and pain. In 09/14/2016, he was sent for ultrasound which revealed a 6.8 x 5.5 x 5.5 cm right testicular mass. Ultrasound also showed a retroperitoneal mass that measures 6.8 x 5.9 x 7 cm between the aorta and left kidney. The left testicle was normal. On 09/23/2016, he underwent a CT scan which showed extensive retroperitoneal lymphadenopathy with dominant left periaortic lymph nodes with a mass extending into the level of the left renal artery which was partially encased down to the aortoiliac bifurcation. The mass measured 8.3 x 7.1 cm. The mass abutted and appeared to be partially encased in the left renal vein which was displaced anteriorly. Alpha-fetoprotein was 5.4, and beta HCG was 11.2, and LDH was 484. The patient subsequently, underwent a right radical orchiectomy without complication on …show more content…
Generally, this is a well-developed man sitting comfortably in no acute distress. Skin is warm and dry. HEENT: Head is normocephalic and atraumatic. Pupils are equal and reactive to light and accommodation. Sclerae are anicteric. Oral mucosa is moist without lesions. No JVD. No thyromegaly. Lymphatics: No cervical, supraclavicular, axillary, or inguinal adenopathy is appreciated. Respiratory: Lungs are clear to auscultation bilaterally. Heart: Regular rate and rhythm. Abdomen: Soft and nontender. Positive bowel sounds. Liver and spleen not palpable. Strength is 5/5 throughout. Neurological exam is