A 23-year-old man is evaluated because of a painless right-sided scrotal mass. Ciprofloxacin, 500 mg every 12 hours, is administered for 10 days, but he notes little improvement in the swelling. His serum -fetoprotein level is elevated at 100 ng/mL, and his 13-human chorionic gonadotropin level is 64 m/UImL. Testicular ultrasound examination reveals a hypoechoic mass. Which of the following would be the most appropriate next step in his treatment?

Retroperitoneal lymph node dissection

Combination chemotherapy with bleomycin, etoposide, and cisplatin

A 23-year-old man is evaluated because of a painless right-sided scrot

1.	A 23-year-old man is evaluated because of a painless right-sided scrotal mass. Ciprofloxacin, 500 mg every 12 hours, is administered for 10 days, but he notes little improvement in the swelling. His serum -fetoprotein level is elevated at 100 ng/mL, and his 13-human chorionic gonadotropin level is 64 m/UImL. Testicular ultrasound examination reveals a hypoechoic mass. Which of the following would be the most appropriate next step in his treatment?
A.	Retroperitoneal lymph node dissection
B.	Combination chemotherapy with bleomycin, etoposide, and cisplatin
C.	Radiation to the pelvis
D.	Inguinal orchiectomy
Answer» E.

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