Abstract
Zondek, 1 Heidrich, Fels and Mathias 2 and Hady 3 have reported obtaining a positive Ascheim Zondek reaction in cases of chorionepithelioma testis.
Stimulated by these reports we have had the opportunity to study a case of testicular tumor admitted to the surgical ward of the University of Pennsylvania Hospital.
The patient, H. A., a white male, age 24, was admitted with a history of a firm mass the size of a golf ball in the right testis of two months duration. There was a slightly visible and definitely palpable intumescence and induration about 4 cm. in diameter under each areola of the breasts.
The right testicle and the distal end of the spermatic cord were removed at operation and a tumor 3 cm. in diameter involving the lower pole of the testis and infiltrating the seminiferous tubules was found.
Three months later, with no clinical evidence of the presence of metastasis of the tumor, a morning specimen of urine was obtained and 24 cc. of urine were injected intravenously into an isolated nonpregnant female rabbit according to the method described by Friedman and Lapham. 4 On sacrificing the rabbit several corpora lutea and corpora hemorrhagica were found in both ovaries resembling exactly the reaction obtained on injection of urine of pregnancy.
The pathological report by Dr. Joseph MacFarland on microscopic examination of the tissue after the test was teratoma of the testis.
In view of these results it is quite evident that this reaction may be of value in establishing a diagnosis of teratoma testis and also in the determination of the presence of metastatic tumor tissue of this character.
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