1: Urological Malignancies - Testicular Cancer Flashcards
What is the commonest malignancy in males 20-30 years-old
Testicular cancer
If a 20-30 year-old was going to be diagnosed with cancer what would it be
Testicular cancer
What are 5 RF for testicular cancer
- FH
- Cryptorchidism
- Klinefelter
- Mumps orchitis
- Infertility (3-times)
What % tumours are bilateral in testicular cancer
5%
What % tumours occur in cryptorchdisim
10%
how does testicular cancer present clinically
- painless swelling of the testicle
- dull discomfort
- haematospermia
on examination of the lump in testicular cancer what will it not do
transilluminate
what are the two main classification of testicular cancer
- Germ cell
- Non Germ cell tumours
what are the two types of germ cell tumours
Seminoma
Non-seminoma
what % of germ-cell tumours are seminomatous
55%
name 5 germ cell non-seminomatous cancers
- Embryonal
- Teratoma
- Testicular choriocarcinoma
- Yolk sac tumour
- Mixed germ cell tumour
what are the two non germ-cell tumours
Leydig
Secondary tumours
what is a secondary testicular tumour
Lymphoma
what is the most common testicular tumour in men over 60
Lymphoma (Secondary Testicular Tumour)
Where to testicular tumours typically metastasise to
Para-aortic lymph nodes
What testicular tumours are most likely to metastasise
Non-seminoma germ-cell tumours
What 3 enzymes are raised in germ cell testicular cancer
AFP
LDH
bHCG
What enzyme is most associated with germ-cell testicular cancers
AFP (60%)
What % of germ-cell tumours have raised LDH
40%
What % of germ-cell tumours have raised bHCG
20%
What is first-line investigation for testicular cancer
USS
If testicular cancer is found what is ordered to stage disease
CT CAP
What is stage 1 testicular cancer
No mets
What is stage 2 testicular cancer
Infra-diaphragmatic lymph node mets
What is stage 3 testicular cancer
Supra-diaphragmatic lymph node mets
What is stage 4 testicular cancer
Lung involvement
What is first-line for testicular cancer
Inguinal radical orchidectomy
Where is the incision made in radical inguinal orchidectomy and why
Inguinal region and spermatic cord compressed - this is done to prevent seeding
What type of testicular cancer is radiotherapy sensitive
Seminoma
How many cycles is usually required in NSGCT
3-cycles
Outline prognosis in testicular cancer
Very good prognosis
What is the average age of individual when diagnosed with seminomatous germ cell tumour
40-years
What is prognosis of seminomatous germ cell tumour
very good
How does AFP present in seminomatous germ cell tumour
normal
What % of seminomatous germ cell tumours have raised HCG
10
What % of seminomatous germ cell tumours have raised LDH
20
What age do non-seminomatous germ cell tumours present
younger: 20-30’s
Wha is prognosis of non-seminomatous germ cell tumours
poor
What % of non-seminomatous germ cell tumours have raised AFP
70
What % of non-seminomatous germ cell tumours have raised HCG
40
