Testicular Cancer Flashcards
Where do testicular cancers normally arise from?
Arise from germ cells (resp for producing gametes)
What are the 2 main types of testicular cancer?
Seminomas
Non-seminomas (tend to be teratomas)
Who is most likely to develop testicular cancer?
What are the risk factors?
What are risk factors for germ cell tumours?
Young men (15-35 yo have the highest incidence)
Undescended testes
Male infertility
FH
Increased height
Klinefelter syndrome (XXY) -dysgenesis of seminiferous tubules causing testicular atrophy/infertility/gynaecomastia
Cryptochidism
-failure of testes to descend into testes
How would someone with testicular cancer typically present?
Painless lump on testicle
Characteristics of lump:
- non-tender
- arising from testicle
- hard
- irregular
- non-fluctuant
- no transillumination
Can present with hydrocele or varicocele
Abdo or testicular pain
“Dragging” sensation in testes
Gynaecomastia
-rare presentation with rare type of testicular cancer= Leydig cell tumour
What investigations should be done it testicular tumour is suspected?
Why are testicular cancers NOT biopsied?
Scrotal ultrasound
Blood test for tumour markers:
- alpha-fetoprotein= raised in non-seminomas
- beta-HCG= raised in seminomas and non-seminomas
- LDH= very non-specifc tumour marker
Biopsy comes with high risk of seeding to scrotum and facilitates local spread
What is the staging system used for testicular cancer?
Royal marsden staging
What are the common sights of metastasis with testicular cancer?
Lymphatics
Lungs
Liver
Brain
How is testicular cancer managed?
Radical orchidectomy to remove the affected testicle and insert a prosthesis instead
Chemo
Radio
Sperm banking due to risk of infertility with treatment
What are the potential long term SE of treatment?
Infertility Hypogonadism-> may need testosterone replacement Peripheral neuropathy Hearing loss Kidney/liver/heart damage Increased risk of cancer for future
