Clinical History:  A 41-year-old male sustained trauma to the scrotal area when an errant pass struck him during a basketball game. Subsequent examination of the testes demonstrated firm, painless enlargement of the right testicle. The testicular contour was smooth on examination. Orchiectomy was performed.

Questions:

1. Figure C1 - Gross specimen from orchiectomy.  From the gross appearance, what is the differential diagnosis?

2. Figure C2 & Figure C3 - Histology of the surgical specimen.  Describe the populations of cells present (benign and/or malignant), which characterize this neoplasm.  What is the histogenetic origin of this neoplasm?

3. Discuss the therapy of metastatic disease in a patient such as this.