A case report of scrotal mass the first clinical manifestation of multiple myeloma

 Testicular tumor is one of the rarest tumors that accounts for 1-2% of male tumors and 95% of them are germ cells. The present study reported a case of scrotum mass, the first clinical manifestation of multiple myeloma.

Case Report: 

The patient was a 48-year-old man with a large mass without pain in the left scrotum and referred to a urology clinic. There was no bone pain, lethargy, or weakness on clinical examination. Vital signs, heart, lung, and abdominal examinations were all normal. Ultrasound showed a large 10-cm-diameter Izuaco mass in the left hemiscrotum with inflammation and edema of the scrotum wall. With the diagnosis of a left testicular tumor, the decision was made to perform surgery.

 In this patient, coagulation disorder and subsequent mild trauma to the testicle, which the patient does not remember, may have caused bleeding in the testicle and a mass in it. Of course, the presence of anemia should suggest other differential diagnoses. However, the lack of tumor reporting in the sample sent to the laboratory necessitates further investigation. Recurrent hematoma at the site of surgery in this patient and the impossibility of determining blood type raised the suspicion of high proteins in the blood, which together with high ESR serum despite the relatively young age of the patient led us to the diagnosis of multiple myeloma.