A 22yearold male presents with a scrotal mass that does not

A 22-year-old male presents with a scrotal mass that does not transilluminate. An orchiectomy reveals embryonal carcinoma with teratoma. Chest x-rays and lung tomograms are normal. Serum AFP (alpha-fetoprotein, a protein secreted by tumor cells. is elevated. Abdominal CT scan reveals minimal retroperitoneal lymphadenopathy. Retroperitoneal lymphadenectomy indicates 4 of 42 nodes positive for embryonal carcinoma. Six months after the node dissection the patient remains asymptomatic but his chest x-ray reveals pulmonary metastases. AFP is slightly elevated. Chemotherapy (cisplatin, vinblastine, and bleomycin) is given over 12 weeks. One month after completion of chemotherapy a thoracotomy is done and residual lung lesions are removed. He remains free of disease 32 months after the start of chemotherapy.

1. What is the diagnosis for this patient? B

A. Prostate cancer

B. Testicular cancer

C. Benign prostatic hyperplasia

D. Lung cancer

2. What was the primary method of treatment? D

A. Chemotherapy

B. Radiation therapy

C. Surgical removal of the prostate gland

D. Surgical removal of a testis

3. What other surgical procedure was done to stage the patient’s condition? D

A. Removal of tumor from the lung

B. Chest x-ray

C. Removal of pelvic lymph nodes

D. Removal of lymph nodes behind the membrane lining the abdominal cavity

4. What treatment was initially given for spread of the tumor to the lungs? C

A. Drug treatment with AFP

B. Thoracotomy

C. Chemotherapy

D. Retroperitoneal lymphadenectomy

Solution

Ans.1. After orchiectomy carcinoma reveals that means patient is suffering from Testicular cancer. so option B is correct.

2. the primary method of treatment is Orchiectomy i.e surgical removal of one or both testis, so option D is correct.

3. RPLND i.e retroperitoneal lymph node dessection other surgical method is used to detect testicular cancer, so option D is correct

4. Chemotherapy is given to for spread of the tumor to the lungs, so option C is correct