A 28-year-old man presents with a painless testicular mass. Biopsy confirms seminoma. To which group of lymph nodes does the tumour spread first?

• A Superficial inguinal nodes
• B Para-aortic (lateral aortic) nodes at the level of L2 ✓
• C External iliac nodes
• D Internal iliac nodes

Explanation

The testis develops on the posterior abdominal wall beside the kidneys and its lymphatics follow the testicular vessels back to their origin. Primary drainage is therefore to the para-aortic nodes at the level of the renal vessels, around L2. The superficial inguinal nodes drain the scrotal skin and penis, not the testis itself, which is the single most tempting distractor and the point that kills option A.

Reference: Moore Clinically Oriented Anatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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