Penile & Testicular Cancer

Question 1

What are the risk factors for testicular cancer?

Answer 1

TC in contralateral testicle
Cryptorchidsm - before 13 2 fold increased risk after it rises to 5 fold 
HIV 
Family history 
White caucasian

Question 2

What are the two main types of testicular cancer?

Answer 2

Seminoma and non-seminomatous

Question 3

Describe seminomatous testicular cancer

Answer 3

34-45 years old, uniform lobulated cut surface with large cells that have a clear cytoplasm and vesicular nuclei

Question 4

What are the different types of non-semionmatous testicular cancer?

Answer 4

• mature teratoma
• yolk sac (alpha feto protein)
• embryonal (aggressive, high grade, frequent mets)
• trophoblast (positive for hCG)
• choriocarcinoma

Question 5

Who is more likely to get non-semionmatous cancer?

Answer 5

<35 year old

Question 6

What cells are involved in a mixed germ cell tumour?

Answer 6

Sex cord stromal
Lydia cell
Sertoli cell

Question 7

How will testicular cancer present?

Answer 7

Scrotal lump with acute pain due to bleeding

Question 8

What will the examination findings of testicular cancer be?

Answer 8

Scrotal discolouration, hard, non-tender irregular mass, involvement of surrounding structures or secondary hydrocoele

Question 9

How is testicular cancer investigated?

Answer 9

Ultrasound, CT chest abdomen for staging

Blood test - alpha feto protein, bhGC, LDH, liver and renal function

Question 10

How is testicular cancer treated?

Answer 10

Radical inguinal orchidectomy

Chemotherapy as adjuvant treatment even in non-metastatic cases

Question 11

What type of cancer are most penile cancers?

Answer 11

Squamous cell carcinoma

Question 12

Name other types of tumour that can present on the penis

Answer 12

• kaposi’s sarcoma
• BCC
• Malignant melanoma
• Sarcoma

Question 13

What are the risk factors for penile cancer?

Answer 13

40-60 years old, phimosis, HPV 16/18, smoking, immunocompromised

Question 14

Where can penile cancers arise on the penis?

Answer 14

• glans
• prepuce
• glans and prepuce
• coronal sulcus
• shaft

Question 15

How do penile cancers present?

Answer 15

Hard painless lumps usually delayed for a year due to psychosocial factors. Rarely present with urinary retention or groin mass

Question 16

What investigations are done for suspected penile cancer?

Answer 16

MRI - assess tumour depth

CT abdomen, pelvis, chest

Question 17

How are penile cancers treated?

Answer 17

Prepucial lesion - circumcision 
Glans lesion 
- superficial - resurfacing 
- deep - glansectomy 
Amputation and urethrostomy formation may be required in advanced disease

Question 18

Where is the end of the urethra after urethrostomy?

Answer 18

Perineum