Oncology Case Challenge: A 45-Year-Old Father Seeking Vasectomy Has Alarming Findings

Anand D. Patel, MD; Eric Fox, DO; Joshua Wright


May 10, 2022

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.


A 45-year-old man is referred to a urologist for a vasectomy. He is healthy and has no past surgical or significant medical history. His social history is positive for past tobacco use (one pack per day from age 21 to 26 years) and occasional alcohol use (once a week). He does not report any illicit drug use. The patient is married and has two young, healthy children.

He states that he moved around frequently while he was growing up as an "Army brat" and lived on military bases. Both of his parents are Army veterans and are in good health. His father has a history of tobacco use and depression.


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