Testicular cancer

Question 1

Define testicular cancer

Answer 1

Malignant tumour of the testes

Question 2

Types of testicular cancer & prevalence

2 + 2

Answer 2

Seminomas - 50%
Non-seminomatous germ-cell tumours & teratomas - 30%
RARE: gonadal stromal tumours (Sertoli & Leydig cell tumours) & non-Hodgkin’s lymphoma

Question 3

Aetiology of testicular cancer

Answer 3

Unknown

Question 4

Risk factors for testicular cancer

3

Answer 4

Maldescended testes
Ectopic testes
Atrophic testes

Question 5

Epidemiology of testicular cancer

general, male, age

Answer 5

UNCOMMON
1% of male malignancies
Common age of onset 18-35 yrs

Question 6

Presenting symptoms of testicular cancer

3

Answer 6

Swelling or discomfort of the testes
Backache due to para-aortic lymph node enlargement
Lung metastasis - SOB, haemoptysis

Question 7

Signs of testicular cancer on physical examination

4

Answer 7

Painless, hard testicular mass
May be secondary hydrocoele
Lymphadenopathy
Gynaecomastia

Question 8

Investigations for testicular cancer

5

Answer 8

Bloods
Urine pregnancy test
CXR
Testicular US
CT abdo & thorax

Question 9

Investigations for testicular cancer - bloods

4

Answer 9

FBC
U&Es
LFTs
Tumour markers - α-fetoprotein, β-HCG, LDH

Question 10

Investigations for testicular cancer - urine pregnancy test

Answer 10

Positive if tumour produces β-hCG

Question 11

Investigations for testicular cancer - CXR

Answer 11

Shows lung metastases

Question 12

Investigations for testicular cancer - testicular US

2

Answer 12

Allows visualisation of tumour

Can see associated hydrocele

Question 13

Investigations for testicular cancer - CT abdo & thorax

Answer 13

Allows staging (Royal Marsden Hospital staging)