Treatment of seminoma is:
Ans: a (High orchidectomy with radiotherapy) Ref: Bailey & Love, 24thed,p. 1411Treatment of testicular neoplasm involves high orchidectomy for tissue diagnosis and further management depending on the nature of tumour and the extent of lymphatic spread. So the obvious answer is high orchidectomy with radiotherapyStageExtent of diseaseSeminomaNonseminomaIATestis only, no vascular/ lymphatic invasion (Tl)High orchidectomy with radiation therapyHigh orchidectomy RPLND or observationIBTestis only with vascular/ lymphatic invasion (T2) or extension through tunica albuginea(T2) or involvement of spermatic cord (T3) or scrotum (T4)High orchidectomy with radiation therapyHigh orchidectomy with RPLNDIIANodes < 2 cmHigh orchidectomy with radiation therapyHigh orchidectomy with RPLND or chemotherapy often followed by RPLNDIIBNodes 2 -5 cmHigh orchidectomy with radiation therapyHigh orchidectomy RPLND +/- adjuvant chemotherapy or chemotherapy followed by RPLNDIICNodes > 5 cmHigh orchidectomy ChemotherapyHigh orchidectomy, chemotherapy, often followed by RPLNDIIIDistant metastasisHigh orchidectomy ChemotherapyHigh orchidectomy, chemotherapy, often followed by surgery (biopsy or resection)Tumorus of testis* Seminoma (40%): B/w 35 and 45 yrs* Teratoma (32%): Younger age group peak incidence b/w 20 & 35 yrs* Combined seminoma & teratoma (14%)* Interstitial tumours (1.5%)* Lymphoma (7 %): Men over 60 yrs* Others (5.5%)Note:Transscrotal approach in neoplasm of testis is contraindicated because of early spread of malignancy to scrotal skin.
High orchidectomy with radiotherapy
Radiotherpy
Chemotherapy only
Trans scrotal resection of testis
Testis & Scrotum