PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the standard surgical treatment for testicular carcinoma?

1. Open radical nephrectomy

2. Inguinal orchiectomy with retroperitoneal lymph node dissection

3. Transurethral resection of the bladder

4. Laparoscopic cholecystectomy

The correct answer is: Inguinal orchiectomy with retroperitoneal lymph node dissection

The standard surgical treatment for testicular carcinoma is inguinal orchiectomy with retroperitoneal lymph node dissection. The rationale for this approach lies in the need to both remove the affected testicle and evaluate the lymph nodes for any potential metastasis. Inguinal orchiectomy involves the complete removal of the affected testis through an incision in the groin, ensuring that the entire tumor is excised and minimizing the risk of tumor spillage, which could occur with other types of procedures. This is a critical first step in the management of testicular cancer, as it allows for accurate staging of the disease through the histological examination of the tumor. Following this, retroperitoneal lymph node dissection is performed when there is high suspicion or confirmation of nodal involvement. This procedure allows for the removal of lymph nodes located near the aorta and inferior vena cava, which are known to be the common sites for metastasis in testicular cancer. The combination of these two surgical interventions not only provides definitive treatment but also assists in staging and planning further adjuvant therapy if necessary. In contrast, the other options presented are unrelated to the treatment of testicular carcinoma. An open radical nephrectomy is performed for kidney cancers,