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4. 1 and 3
Now that a lesion has been identified and is the presumed source of the seizure, the question is whether this is a primary brain tumor or metastatic. Based on the brain MRI the radiologist favored the later. Testicular cancer is not uncommon in young adult men and could be a source for a metastatic lesion in the brain. In addition, there are a number of processes in the chest which might result in brain lesions. It is unclear how a CEA antigen would be helpful.
Testicular examination was unremarkable. The chest X-ray was interpreted as showing small nodules at the lung bases.
What should be done next? (Click on the correct answer to procced to the fifth of seven panels)