Which of the following is not seen in testicular carcinoma?

Testicular tumors MC presentation is a nodule or painless swelling of one gonad. 10% patients present with acute pain or manifestation due to secondaries like neck or abdominal masses, GI disturbances, respiratory or CNS symptoms, bone pain or lumbar backache due to nerve roots involvement by bulky retroperitoneal disease Secondary hydrocele is also seen in 5-10% cases 5% GCT may present with gynecomastia as a systemic endocrine manifestation Gynecomastia is more common seen with sex cord or gonadal stromal tumors (Leydig cell tumor, seoli cell tumor, Granulosa cell tumor/Theca cell tumor) Majority (2/3rd) of seminoma are confined to testis at the time of presentation, whereas majority of non-Seminomatous GCT have widespread metastasis at presentation Many patients would present with a history of trauma, but trauma merely draws the attention of the patients and has no etiological association with tumor Any patients with a solid form intra testicular mass must be considered to have testicular tumor unless otherwise proved Bilateral testicular tumors Bilateral testicular tumors are seen in 1-2% cases Primary bilateral testicular tumors have Tendency of same histology on both sides Seminoma is the MC histological finding in bilateral primary testicular tumor, whereas malignant lymphoma is the MC bilateral testicular tumor Ref: Bailey and love 27th edition Pgno : 1506