Stage I seminoma testis, t/t of choice is

Ans. is 'b' i.e. high inguinal orchidectomy & radiotherapy Testicular Cancer - is mainly of two types - Germ cell tumors (GCT) 95% - Non germinal neoplasms -- 5% (includes leydig cells, seoli cells, gonadoblastoma) Germ cell tumors are of 2 types Seminomas (More common, better prognosis) Nonseminomas i.e. - Embryonal Ca Teratoma Choriocarcinoma Yalk sac (Endodermal sinus) Carcinoma Germ Cell Tumor Staging and Treatment Treatment Stage Extent of Disease Seminoma Nonseminoma IA Testis only, no vascular/ lymphatic invasion (TI) Radiation therapy RPLND or observation IB Testis only, with vascular/ lymphatic invasion (T2), or extension through tunica albuginea (T2), or involvement of spermatic cord (T3) or scrotum (T4) Radiation therapy RPLND HA Nodes <2 cm Radiation therapy RPLND or chemotherapy often followed by RPLND BE Nodes 2-5 cm Radiation therapy RPLND +/- adjuvant chemotherapy or chemotherapy followed by RPLND IIC Nodes >5 cm Chemotherapy Chemotherapy, often followed by RPLND III Distant metastases Chemotherapy Chemotherapy, often followed by surgery (biopsy or resection) RPLND : retroperitoneal lymph node dissection Extra gonadal Germ cell tumors --> Infrequently GCTs arise from an extra gonadal site. They have poor prognosis. They are treated by chemotherapy.