Abstract
Testicular microlithiasis (TM) is a condition in which punctate calcifications are present in the testicle. A case of a 29-year-old Saudi male who developed a cough, hemoptysis, and shortness of breath is presented in this report. A computed tomography (CT) scan of the chest revealed a large mediastinal mass. CT scans of the abdomen and pelvis were normal. Testicular ultrasonography (US) showed multiple, bilateral punctate echoes that are characteristic of TM. No primary testicular tumor was detected. Transthoracic needle biopsy of the mediastinal tumor was consistent with a mixed germ cell tumor. This is the seventh case of extragonadal germ cell tumor with TM.