Question

What is the treatment for a stage I testicular tumor?

• A. High orchidectomy
• B. High orchidectomy plus radiotherapy
• C. Scrotal orchidectomy
• D. Bilateral orchidectomy

Hint:

Seminoma spreads early to para-aortic nodes and responds well to radiation.

Answer 1

The Correct Option is B

Step 1: Recall the standard first step for any testicular tumor.
Every suspected testicular tumor is removed through the groin, called a radical inguinal (high) orchidectomy, along with the spermatic cord up to the internal ring. This gives the diagnosis, the tumour type, and local control together.

Step 2: Understand what stage I means.
Stage I disease means the tumour is confined to the testis, with no spread to lymph nodes or distant organs on imaging. Testicular tumours, most often seminomas, spread first through the lymphatics to the para-aortic (retroperitoneal) lymph nodes.

Step 3: Understand why radiotherapy is added.
Seminoma is a very radiosensitive tumour. Even in stage I disease, a small number of patients can have microscopic spread that imaging misses. Adjuvant radiotherapy to the para-aortic nodal region after orchidectomy has classically been used to treat this hidden disease and cut down relapse.

Step 4: Rule out the other options.
High orchidectomy alone, without any further treatment, leaves microscopic nodal disease untreated in a proportion of patients, so relapse rates are higher when nothing more is done.
Scrotal orchidectomy is avoided on purpose. Cutting through the scrotum instead of the groin risks seeding tumour cells into the scrotal lymphatics and skin, so it is not the correct approach.
Bilateral orchidectomy removes both testes, which is not needed since disease is confined to one testis; this would cause needless loss of the healthy testis and hormone function.

Step 5: Note on modern practice.
Today, active surveillance after orchidectomy alone is also an accepted option for many stage I seminoma patients, since it avoids radiotherapy side effects, but high orchidectomy plus radiotherapy remains a standard, well established answer for stage I seminoma in exam settings.

Step 6: Final answer.
\[ \boxed{\text{High orchidectomy plus radiotherapy}} \]