Shyam, a 50 years old male presents with a hard scrotal swelling. All of the following can be done, EXCEPT:
Trans-scrotal biopsy is contraindicated in the diagnostic workup of a suspected testicular neoplasm, as this procedure can disrupt regional lymphatics, potentially altering the otherwise predictable nodal spread. The preferred diagnostic and therapeutic procedure for a testicular mass is radical inguinal orchiectomy. If a tissue diagnosis is felt to be necessary prior to orchiectomy, an open biopsy should be performed an inguinal incision to allow for proper examination and tissue sampling with minimal risk of inguinal or scrotal contamination. Ref: Brooks H.D., Pagliaro L.C., Lim Z.D., Pisters L.L., Tannir N.M. (2011). Chapter 36. Germ Cell Tumors. In H.M. Kantarjian, R.A. Wolff, C.A. Koller (Eds), The MD Anderson Manual of Medical Oncology, 2e.
Testicular biopsy
Chest x-ray
Inguinal exploration
CT abdomen