Cryptorchidism is associated with increased risk testies ca

Discussion in 'MRCS Forum' started by Javed., Jan 24, 2008.

  1. Javed.

    Javed. Guest

    Q. A 28-year-old medical student seeks your attention because of testicular mass. You recommended a biopsy. Subsequently, you must plan for optimal operative and perioperative therapy. Which of the following statements regarding testicular cancer is true?

    a- Lymph node dissection after orchiectomy is useful for staging but does not increase survival
    b- Seminomas and choriocarcinomas are best treated with orchiectomy and retroperitoneal lymph node dissection
    c- Seminomas are extremely resistant to radiotherapy
    d- Orchiectomy for a testicular mass is approached via the scrotum
    e- Cryptorchidism is associated with an increased risk of testicular cancer
  2. Javed.

    Javed. Guest

    Answer: e. (Schwartz, 7/e, pp 1794-1795) After radical orchiectomy, lymph node dissection is indicated in embryonal carcinoma, teratocarcinoma, and adult teratoma if there is no supradiaphragmatic spread. This dissection increases the 5-year survival and helps in staging. Seminoma is extremely radiosensitive and lymph node dissection is unnecessary. Choriocarcinoma is associated with pulmonary metastases in 81% of cases and is treated with chemotherapy. Orchiectomy for a testicular mass is approached via an inguinal incision in order to perform a high ligation of the cord and to eliminate spread of the tumor. Cryptorchidism (undescended testicle) is associated with decreased spermatogenesis and carries a lifelong risk of malignant degeneration even after being surgically corrected.

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