A presenting symptom of a testicular malignant tumor may include:

In the context of testicular malignant tumors, it's important to consider the range of symptoms that may present in patients. Testicular cancer can lead to various complications and associated symptoms, reflecting its impact on surrounding structures and lymphatic drainage.

Para-aortic lymphadenopathy is a common finding because the testicles drain lymphatically to the para-aortic lymph nodes. When malignancy is present, cancerous cells can metastasize to these nodes, leading to noticeable enlargement, which can sometimes be detected via imaging studies during evaluation.

Acute scrotal pain may arise due to several factors in the context of a testicular tumor, such as torsion or associated inflammation. While not all testicular tumors present initially with pain, acute discomfort can occur, particularly if there are complications like hemorrhage or infarction within the tumor.

Retroperitoneal lymphadenopathy is also a possible manifestation. Testicular tumors can metastasize to the retroperitoneal lymph nodes as the cancer progresses. This local spread can result in retroperitoneal mass effects, which can lead to pain, discomfort, or other systemic symptoms.

Since each of these symptoms can present in patients with testicular tumors at different stages, the correct answer encompasses the understanding that all of these