A 27-years old man presents with a left testicular tumor with a 10 cm retroperitoneal lymph node mass. The treatment of choice is:
Ans. (c) Left high inguinal orchiectomy plus chemotherapyGerm Cell Tumor Staging andTreatmentExtent of DiseaseSeminomaNon seminoma* Testis only, no vascular/lymphatic invasion (T1)Radiation therapyRPLND or observation* Testis only, Vascular/lymphatic invasion (T2),* Tunica albuginea (T2),* Involvement of spermatic cord (T3)* Scrotum (T4)Radiation therapyRPLNDNodes <2cmRadiation therapyRPLND or chemotherapy often followed by RPLNDNodes 2-5cmRadiation therapyRPLND+/-adjuvant chemotherapy or chemotherapy followed by RPLNDNodes >5cmChemotherapyChemotherapy, often followed by RPLNDDistant metastasesChemotherapyChemotherapy often followed surgery (biopsy or resection)
Radiotherapy
Immunotherapy with interferon and interleukins
Left high inguinal orchiectomy plus chemotherapy
Chemotherapy alone
Urethra & Penis