Testicular cancer Flashcards
What are the 2 types of testicular cancer?
Seminoma
Teratoma
What does seminoma affect?
Seminiferous tubules
What does teratoma affect?
Mature and immature germ cells
Which form of testicular cancer has a better prognosis?
Seminoma
What are possible risk factors for testicular cancer?
- infertility
- cryptorchidism
- family history
- Klinefelter’s syndrome
By how much does infertility increase the risk of testicular cancer?
Increases the risk by 3x
How does testicular cancer present?
- Firm lump on testis
- Gynaecomastia
- Hydrocele
- Back pain
Why would you get back pain with testicular cancer?
Spread to para-aortic lymph
What is first line in the diagnosis of testicular cancer?
Ultrasound
Which tumour biomarker is related to teratoma?
Alpha-fetoprotein (AFP)
Which tumour biomarker is related to seminoma?
HCG is elevated in around 20% of seminomas
Which tumour biomarker is related to Choriocarcinoma?
B-human Chorionic Gonadotrophin
What would you use to look for metastasis?
Staging CT
What is the management of seminoma?
Chemotherapy and Radiotherapy
What is the management of teratoma?
Radical Orchidectomy
removal of testicle and spermatic cord
What is a possible side effect of radical orchidectomy?
Reduced fertility
What is the main presentation of testicular cancer?
Painless lump on testicle
How can the testicular lumo be described?
Non-tender (or even reduced sensation)
Arising from testicle
Hard
Irregular
Not fluctuant
No transillumination
How is testicular cancer staged?
Royal Marsden Staging System
What is stage 1 testicular cancer?
Isolated to the testicle
What is stage 2 testicular cancer?
Spread to the retroperitoneal lymph nodes
What is stage 3 testicular cancer?
Spread to the lymph nodes above the diaphragm
What is stage 4 testicular cancer?
Metastasised to other organs
Can the testicular lump be separated from the underlying testicle?
No
What type of cancer is testicular cancer?
Germ cell tumours
What does a raised AFP exclude?
It excludes a seminoma
