<prompt> Stage I seminoma testis, tt of choice ishigh inguinal orchidectomyhigh inguinal orchidectomy radiotherapyradiotherapy and chemotherapytrans-scrotal orchidectomy  <response>: Ans. is b i.e. high inguinal orchidectomy radiotherapy Testicular Cancer - is mainly of two types - Germ cell tumors GCT 95 - Non germinal neoplasms -- 5 includes leydig cells, seoli cells, gonadoblastoma Germ cell tumors are of 2 types Seminomas More common, better prognosis Nonseminomas i.e. - Embryonal Ca Teratoma Choriocarcinoma Yalk sac Endodermal sinus Carcinoma Germ Cell Tumor Staging and Treatment Treatment Stage Extent of Disease Seminoma Nonseminoma IA Testis only, no vascular lymphatic invasion TI Radiation therapy RPLND or observation IB Testis only, with vascular lymphatic invasion T2, or extension through tunica albuginea T2, or involvement of spermatic cord T3 or scrotum T4 Radiation therapy RPLND HA Nodes 2 cm Radiation therapy RPLND or chemotherapy often followed by RPLND BE Nodes 2-5 cm Radiation therapy RPLND - adjuvant chemotherapy or chemotherapy followed by RPLND IIC Nodes 5 cm Chemotherapy Chemotherapy, often followed by RPLND III Distant metastases Chemotherapy Chemotherapy, often followed by surgery biopsy or resection RPLND : retroperitoneal lymph node dissection Extra gonadal Germ cell tumors -- Infrequently GCTs arise from an extra gonadal site. They have poor prognosis. They are treated by chemotherapy. 