Pathological Case of the Month

A BLACK boy was born by spontaneous vaginal delivery at 39 weeks' gestation to a 23-year-old gravida 3, para 0, aborta 2 woman with an uneventful prenatal course. No significant medical, social, or family history was elicited. No gross abnormalities were noted on physical examination of the newborn except for the presence of reducible bilateral scrotal masses diagnosed as hydrocele. The infant was discharged from the hospital on day 3. At age 4 months, he was seen at the pediatric clinic for evaluation of an indurated right hemiscrotal mass that, according to the patient's mother, seemed to be enlarging. The infant was referred to a urologist, but follow-up evaluation was inexplicably delayed until the age of 7 months. The urologist palpated a nodular mass in the right hemiscrotum; the left testis was undescended. A scrotal ultrasonographic scan revealed a hyperechoic mass within the right hemiscrotum. On surgical exploration, a 7.0×3.5×2-cm,