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Presentation 42 year old male presented with enlargement of both testicles
 
Type your diagnosis in the box below. Submit one diagnosis only - if there is more than one pathology, submit only the most clinically significant one. DO NOT submit a differential consisting of several possible diagnoses. If you do so only the first item in the list will be scored. Be as brief and as specific in your diagnosis as possible but DO write out the diagnosis in words. DO NOT use 3 or 4 letter abbreviations because we may not understand what you mean. DO NOT save this page for submitting your guess later. That will cause your answer to appear under a different case and result in the answer being marked as incorrect. When finished, click the submit diagnosis button below. Good Luck!