American Board of Internal Medicine (ABIM) Certification Practice Exam

For patients with stage II seminomas, what type of treatment is typically administered?

1. Adjuvant radiotherapy or cisplatin-based chemotherapy

2. Surgery alone

3. Nothing, as it's self-limiting

4. Palliative care only

The correct answer is: Adjuvant radiotherapy or cisplatin-based chemotherapy

In the management of stage II seminomas, the treatment approach often involves adjuvant therapies due to the risk of metastasis and recurrence. Stage II seminomas are characterized by the presence of lymph node involvement, but they typically still have a good prognosis. The therapeutic options for these patients usually include adjuvant radiotherapy or cisplatin-based chemotherapy, which is standard practice in this context. Cisplatin-based chemotherapy is particularly effective and has become a cornerstone of treatment, providing substantial benefits in terms of disease-free survival. Adjuvant radiotherapy plays a role as well, particularly for patients with certain risk factors, and can also be part of the treatment strategy. The choice between these two modalities may depend on factors such as the extent of the disease, patient preferences, and specific clinical characteristics. Other treatment options, such as surgery alone, would be insufficient since they do not adequately address the systemic risk of metastasis inherent in stage II disease. Likewise, ignoring treatment or considering it self-limiting would not be appropriate given the potential for disease progression, and solely providing palliative care would not meet the clinical need for curative intent or to manage the malignant nature of the disease effectively. Therefore, adjuvant therapies are critical for the