Testicular Cancer

Question 1

What is the commonest malignancy in males ages 15-44?

Answer 1

Testicular cancer

Question 2

What are the common types of testicular cancer?

Answer 2

1. Seminoma (55%)
2. Non-seminomatous germ cell tumour (33%) - yolk sac, choriocarcinoma, teratoma, embryonal carcinoma
3. Can be a combination of the above

Question 3

What are the risk factors for testicular cancer?

Answer 3

Cryptorchidism, FHx, Hx of testicular cancer, testicular atrophy, Caucasian.

Question 4

What is this a presentation of?
Unilateral painless testis lump that is smooth, firm and fixed. Secondary hydrocele. Sometimes pain, bone pain, peripheral oedema, supraclavicular lymph nodes, hyperthyroidism, gynaecomastia.

Answer 4

Testicular cancer

Question 5

How is a suspected testicular cancer investigated?

Answer 5

1. USS is principle test - 100% sensitivity
2. CT AP for staging
3. CXR for lung metastases
4. Serum bhCG, AFP (not seminomas) and LDH may be raised

Question 6

What is the treatment for testicular cancer?

Answer 6

1. Radical orchidectomy and radiotherapy for seminomas (cures 95%)
2. For NSGCT, radical orchidectomy and retroperitoneal lymph node dissection post orchidectomy plus chemotherapy
3. Sperm banking before treatment recommended.