שאלה משלב א׳ בכירורגיה אורולוגית · מועד 2022, שאלה 43

Correct: B — radical right orchidectomy through an inguinal approach. A solid, hypoechoic, vascular intratesticular mass of 18 mm in a young man is a germ cell tumour until proved otherwise, and negative markers and a clear CT do not change that, since roughly a third of testicular tumours are marker-negative. The operation is radical inguinal orchidectomy with high cord ligation: the inguinal route avoids violating the scrotal lymphatics and altering the drainage pattern, which is why trans-scrotal biopsy or partial orchidectomy (options A and D) are contraindicated outside the narrow indications of a solitary testis or bilateral tumours. Surveillance of an undiagnosed solid intratesticular mass (option C) is not acceptable.

מקור: ch.77 ניתוחים לגידולי אשך, עמ ' 1686, 1712