Question

Which should NOT be done in a testicular tumor?

• A. High inguinal orchidectomy
• B. High inguinal orchidectomy with chemotherapy
• C. High inguinal orchidectomy and RT
• D. Transcrotal biopsy for tissue diagnosis

Hint:

Testicular tumor tissue diagnosis and removal go through the groin, never the scrotum.

Answer 1

The Correct Option is D

This question checks which action is wrong in the surgical management of a testicular tumor. The key idea is that a testicular tumor must always be approached through the groin, not the scrotum, because of how the testis drains lymph.

1. High inguinal orchidectomy: This is the correct and standard first operation, removing the testis and cord through a groin incision. Correct step.
2. High inguinal orchidectomy with chemotherapy: Chemotherapy is commonly added after orchidectomy for higher stage or certain tumor types. Correct step.
3. High inguinal orchidectomy and RT: Radiotherapy is added after orchidectomy for radiosensitive tumor types like seminoma. Correct step.
4. Transcrotal biopsy for tissue diagnosis: Cutting through the scrotum to biopsy the tumor crosses into a different lymphatic territory than the one the tumor is expected to spread through, and can seed tumor cells locally. This forces bigger surgery later, so it should not be done.

The only wrong action here is going through the scrotum for a biopsy.

Let's summarize:

• Testicular tumors are always approached and removed through the groin (high inguinal route).
• Chemotherapy and radiotherapy after orchidectomy are both standard, not something to avoid.
• A transcrotal approach risks seeding tumor cells and is avoided.

So the step that should not be done is transcrotal biopsy.