A 28-year-old man presents with a 3-month history of chronic cough and weight loss. Upon further discussion, he mentions the presence of a painless lump in his left testicle. On examination, a firm mass is felt in the left testis. Chest radiograph reveals the pulmonary lesions seen here; scrotal ultrasound confirms the presence of a heterogeneous tumor. Blood tests demonstrate significantly elevated β-human chorionic gonadotropin, slightly elevated lactate dehydrogenase, and normal alpha-fetoprotein levels.
Which testicular malignancy does this patient most likely have?
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