18 y.o. male presents saying, “I may have cancer of my testicle!” He noticed a mass while showering the previous night, and his mother called to have him seen today. He denies any associated pain but says it feels as if he has “grown a third testicle.” He has heard that teens are at heightened risk for testicular cancer. He is athletic and is in the midst of the fall inter-mural soccer season but does not recall an injury in play or practice nor in other activities. He says he does not know how long it has been present, although he thinks he would have felt it by now if it had been this large for long. Past Medical History Asthma, uses a long-acting beta agonist and corticosteroid combination inhaler; does well on this regimen, not experiencing increased symptoms during play Uses topical benzoyl peroxide and clindamycin for mild acne Physical Assessment Vital signs: T 98, BP 98/68, HR 64, HT 70, WT 150 lbs. General: Slender, well-developed young male who appears slightly anxious as he describes his complaint but otherwise in no distress. Genitalia: Assessment of his scrotum-skin is moderate pink, dry, and intact. Noticeable area of enlargement on the left. Right testicle is freely mobile, smooth, and rubbery; ovoid in shape and epididymis is palpable. On the left, testicle is isolated from the mass and is mobile with consistency similar to the right, although there is a mass just proximal to the testicle that is approximately 3 cm in diameter, well-defined with smooth surface and cystic (nonsolid) consistency. Mild discomfort voiced with the assessment. No visible lesions identified. No palpable inguinal nodes. 1.What three conditions would be considered in your differential diagnosis, with the most likely listed first (with rationales)? 2. What further history, further assessments, and diagnostic studies are warranted to explore your differential diagnosis?