Testicular Cancer Related Case Studies done by Dr.Sabyasachi Parida
A young man presented with testicular swelling which had been present for the past several months and gradually increasing in size. It was asymptomatic otherwise. He had consulted several surgeons, all of whom suggested high inguinal orchidectomy, which means removal of the testis and the spermatic cord. This is standard surgery for Cancer Testis.
He had also been advised fnac from the testicular swelling. This is generally avoided in case of testicular cancer for fear of contributing to disease spread…
FNAC was suggestive of a type of being tumour. This cannot be relied on always as certain types of testicular tumours can be misdiagnosed leading to unacceptable mismanagement.
Dr.SabyasachiParida evaluated the case. The patient was understandably worried about the future.
He was counselled and options were discussed in detail. Biochemical tests revealed that it was a non functional tumour, i.e. it was not producing any hormones with known functions.
Imaging was reviewed with the help of Consultant Radiologist. There was a solid lesion at the lower pole of one testis with likely invasion into testicular substance at one point. It was also in close association with lower part of the Epididymis(this conveys sperms out of the testis and is important for testicular aspect of reproductive function).
A small incision was placed over the spermatic cord and testis with its coverings brought out of the scrotum. The lesion was at lower pole of the test is inseparable from testicular substance it was also partially encased by the epididymis.
Epididymis was carefully separated from the lesion. The lesion was then excised from the testis including a cuff of normal testis to achieve clear margins while retaining most of normal testis.
The specimen was then sent for frozen section analysis .This is a quick way of arriving at a pathological diagnosis. It was reported as a type of rare benign tumour.
The testicular wound was closed in an innovative way so that its anatomical and physiological integrity was restored. All testicular coverings were reconfigured. Testis was placed back in to the scrotum and the wound was closed leaving behind an inconspicuous scar.
He is doing well now and the final histopathology report tallied with the frozen section findings. Although it had starred to invade the testicular substance focally, margins were clear as additional testicular margins had been excised keeping in mind ultrasound scan findings.
Hence proper choice of investigative modalities and careful treatment planning and execution saved the