A computed tomography scan revealed a para-aortic lymph node mass in the upper abdomen and enlarged lymph nodes throughout the internal and common iliac lymph node chains.
Assuming the scrotal mass was a carcinoma of the testes, which would normally drain into the lateral aortic (lumbar) nodes in the upper abdomen, it would be very unusual for iliac lymphadenopathy to be present.
Further examination of the scrotal mass was required.