MCQs in Uro- oncology

Q) A patient underwent high inguinal orchidectomy, Biopsy was seminoma . He had a Lymph Node mass 6cm, which after Chemotherapy reduced to 2.5 cm. Next management would be

A) Surveillnace

b) RPLND

c) Radiotherapy

Q2) A 55-year-old male patient presents with scrotal swelling. An ultrasound demonstrates an intra testicular mass. What is the most likely histology of the lesion?

A. Leydig cell tumor

B. Liposarcoma of the spermatic cord

C. Large B-cell lymphoma

D. Granulosa cell tumor

Ans c Lymphoma

Spermatic cord liposarcoma - Extra testicular mass

Granulosa cell tumors - Young

Leydig cell tumor _ Same age group but less common

Q) Landing zone for right tesricular cancer

a) Para aortic nodes
b) Interaortocaval
c) Right obturstor
d) Inguinal nodes

Ans b

Testicular cancers can undergo both lymphatic and hematogenous dissemination.

The lymphatics arising from the testicle accompany the gonadal vessels in the spermatic cord.

Landing zone for metastasis from the right testicle is in the interaortocaval lymph nodes just inferior to the renal vessels ( The landing zone from the left testicle is in the para-aortic lymph nodes just inferior to the left renal vessels Large-volume disease
tends to progress in retrograde fashion to the aortic bifurcation and below, along the iliac vessels

Ref Devita chapter 72