A 25-year-old male presented with painless testicular swelling and with history of fever and weight loss. All the following investigations are indicated in this patient, except:
Ans. (d) Trans-scrotal biopsyRef: Bailey and love, 26th Edition, Pages 1385-1388* Painless testicular swelling in a 25 male with history of fever and weight loss amounts to a diagnosis of malignant testicular swelling, i.e. testicular cancer.* To confirm the histopathological evidence of testicular cancer, orchidectomy in form of high inguinal orchidectomy to be done after a manuever known as Chevasu Manuever* Trans scrotal biopsy is contraindicated, as Tunica albuginea will be breached during biopsy. Since Tunica albuginea is a natural barrier to testicular cancer, following biopsy, this will be breached and extend into the scrotum.
USG scrotum
CT abdomen and pelvis
Chest x-ray
Trans-scrotal biopsy
Urethra & Penis