Careful physical examination of the testis should be supplemented by testicular ultrasonography when abnormalities are present or if there is significant retroperitoneal adenopathy suggesting a testicular primary. There is no role for blind orchiectomy or testicular biopsy in patients with a normal testicular examination and ultrasound. Other investigations such as brain and bone scans should be performed as warranted by symptoms. Buy Advair Diskus Online
Management of Benign Mediastinal Teratoma: Complete resection of benign mediastinal teratoma should result in near universal cure rates and there is no role for radiotherapy or chemotherapy. While these tumors are histologically benign, surgical removal is often difficult. Frequently, these tumors are densely adherent to adjacent structures such as pericardium, lung, and great vessels. These findings sometime necessitate more extensive surgery including pericardiectomy, resection of the phrenic nerve or lobectomy. Nonetheless, in the era of modern thoracic surgery, excellent outcome has been the rule. In a series from the Mayo Clinic, 64 of 69 patients with followup information available were long term, disease-free survivors after surgery alone. Of the five patients not surviving, four died as a result of surgical complications (all prior to 1945) and one died six months after surgery of unknown causes.
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