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Old 07-23-2012
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Question Testicular Mass Before Camping in Colorado!

A 19-year-old man was seen by a local physician for a Boy Scout physical exam. He was to be an Assistant Scoutmaster on a high adventure trek into the mountains of Colorado, lasting for 2 weeks, leaving the coming Friday. Upon physical exam, the physician noticed a 1 cm mass involving the right testis, which could be palpated within the testis proper, not the epididymis. What would be the best diagnosis and clinical recommendation?

a) Benign neoplasm no cause for concern
b) Congenital malformation no cause for concern
c) Epididymitis prescribe antibiotic for his trip
d) Malignant neoplasm cancel trip and schedule surgery
e) Testicular torsion immediately send him to the emergency room
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d) Malignant neoplasm cancel trip and schedule surgery

Any mass in the testis, you "shoot first and ask questions later".
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Aaa..
Should conduct full investigation after trip.
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Quote:
Originally Posted by smanthrav View Post
d) Malignant neoplasm cancel trip and schedule surgery

Any mass in the testis, you "shoot first and ask questions later".

if its seminoma ur suspecting then, y straight away go for surgery..they are radiosensitive tumors right???

my pick would be B.....may be a congenital hydrocele
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Originally Posted by anomali View Post
if its seminoma ur suspecting then, y straight away go for surgery..they are radiosensitive tumors right???

my pick would be B.....may be a congenital hydrocele
Congenital hydrocele isn't palpable as a mass in the testis. and also High level orchidectomy is the first line treatment for suspicious testicular masses(in this case, the age and the lack of concomitant involvement of epididymis as you would see with an infection).

Seminomas are radiosensitive yes, and thats why we use them as adjuvant Rx. These tumours are aggressive and metastasize quickly.
http://www.ncbi.nlm.nih.gov/pmc/arti...tool=pmcentrez
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Quote:
Originally Posted by smanthrav View Post
Congenital hydrocele isn't palpable as a mass in the testis. and also High level orchidectomy is the first line treatment for suspicious testicular masses(in this case, the age and the lack of concomitant involvement of epididymis as you would see with an infection).

Seminomas are radiosensitive yes, and thats why we use them as adjuvant Rx. These tumours are aggressive and metastasize quickly.
http://www.ncbi.nlm.nih.gov/pmc/arti...tool=pmcentrez

well that was very helpful......thanks
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B. congenital
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D)...Cancel the trip..
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Old 07-28-2012
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Default correct answer :)

The answer is D) Malignant neoplasm cancel trip and schedule surgery

This is most likely a seminoma, and should be surgically removed immediately. Two weeks of physically challenging hiking in the remote wilderness is contraindicated, and could even lead to metastasis.

As for A) & B) - Any mass in the testis proper, in a young man, is malignant until proven otherwise.
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