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患者男性,33岁,农民,因头痛、呕吐、左侧偏瘫半月、咳痰带血4天,于1986年11月17日入院。10余年前发现右侧睾丸大于左侧且逐渐长大,近一年来明显增大,并有压痛伴性欲渐退。8年前在公社医院作过右腹股沟疝修补术,生一子已4岁,家族史无特殊。检查慢性病容,正常发育,神志清楚,右肺上部呼吸音降低。外生殖器略小于成年男性,右侧睾丸肿大约7×7×8 cm,质硬,压痛,左侧睾丸轻度萎缩,腹股沟淋巴结双侧肿大、质硬。右侧轻度中枢性面瘫及舌瘫,眼底正常。右上下肢肌力Ⅲ°,腱反射活跃,Babinski(+)。化验:血沉40 mm/h,甲胎蛋白(-),脑脊液压力
The patient, male, 33 years old, was admitted to hospital on November 17, 1986 due to headache, vomiting, partial hemiplegia for the left side, and bloody cough for 4 days. More than 10 years ago, the right testis was found to be larger than the left side and gradually grow. It has increased significantly in the past year and has tenderness with gradual regression of libido. He had had a right inguinal hernia repair at a commune hospital eight years ago. He was 4 years old and had no family history. Check for chronic conditions, normal development, mental clarity, and reduced breath sounds in the upper right lung. The external genitalia is slightly smaller than that of an adult male. The right testis is swollen about 7 × 7 × 8 cm. It is hard and tender, the left testis is slightly atrophic, and the inguinal lymph nodes are bilaterally enlarged and hard. Mild central facial spasm and tongue spasm on right side, normal fundus. Right upper and lower limb muscle strength III °, tendon reflex active, Babinski (+). Laboratory tests: ESR 40 mm/h, alpha fetoprotein (-), cerebrospinal fluid pressure