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An otherwise healthy 28 yr old man comes to his physician because of painless enlargment of right testis.He began to feel a sensation of heaviness in the right hemiscrotum 6 mnths ago.Physical examination reveals diffuse enlargement of the right testis but it is difficult to determine if it is due to a intratesticular or an extratesticular lesion.Which is the appropriate next step in the diagnosis
A. CT Scanning
B. Serum levels of hcG,alphaprotein and LDH
C. Needle biopsy
D. Inguinal orchidectomy
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B. Serum levels of hcG,alphaprotein and LDH - Next Approriate Step, gives us an idea what we are dealing with?
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testis mass is an exception to general surgery rules... you do it first and and the explore the details later as mass in testis most of the time is due to cancer...
So DDD
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Correct answer is A. CT Scanning.USG is the most sensitive and least expensive method to differentiate between testicular and extra testicular masses.Since USG is not given an option, CT scanning can b preferred as the non invasive test.CT is used to determine the spread of the testicular tumors within the abdominal and thoracic cavity.
Serum levels of hCG, AFP and LDH are important parameters in the diagnosis and subsequent management of testiculartumors.LDH may b elevated in seminomas and non seminomas.AFP in non seminomas(Yolk sac tumors) and hCG in non seminomas(Choriocarcinoma)
Inguinal orchidectomy is performed once the USG confirms it to b a testicular tumor.It allows accurate diagnosis and appropriate management.
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eh, intersting....
thanks for the q...
