The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. Patient presentation: A 50-year-old man with a past medical history of hydrocele presents for scrotal swelling. The swelling is bilateral, painless, and has gradually increased in size since it was first noticed 3 months ago. He denies dysuria, hematuria, frequency, fevers, chills, weight changes, abdominal or back pain, or recent injury to the area. Other medical history includes hypertension. There is no history of cryptorchidism, no prior surgeries, and no family history of cancer. He endorses occasional alcohol use but no tobacco use.