testicular cancer

Question 1

how does testicular cancer usually present?

Answer 1

young male with painless testicular lump which is firm

Question 2

what are the 3 main types of testicular cancer?

Answer 2

1. germ cell tumours - most common
2. non germ cell tumours

3, lymphoma-> non hodgkin lymphoma, and most common in elderly

Question 3

what are risk facts for testicular cancer?

Answer 3

Young males: seminoma > 35 years; non-seminoma < 35 years

Caucasian

Family history

Infertility: 3-fold increased risk

Cryptorchidism: highest risk in abdominal and bilateral undescended testes

Intersex conditions: e.g. Klinefelter’s syndrome

Mumps orchitis

Testicular atrophy: often following trauma

Question 4

what type of imaging is used for diagnosis of testicular cancer?

Answer 4

Ultrasound testicular doppler

Question 5

what types of signs and symptoms may be present?

Answer 5

SYMPTOMS:

• Painless lump
• hyperthyroidism because the tumour marker BHCG can mimic thyroid
• breathlessness-> lung mets
• bone pain-> skeletal mets

SIGNS

• firm non tender testicular mass which doe not transluminate
• supraclavicular lymphadenopathy

Question 6

what is the tumour marker present for a seminoma?

Answer 6

Occasionally β-hCG (20%)

Question 7

which types of germ cell tumours have AFP as their tumour marker?

Answer 7

• embryonal carcinoma
• teratoma
• yolk sac tumour

Question 8

which germ cell tumours have BHCG as their tumour marker?

Answer 8

• seminoma

- choriocarcinoma

Question 9

why should biopsy of tumours not be taken for diagnosis?

Answer 9

due to the risk of seeding. Histological examination may be performed post-orchiectomy

Question 10

what is the 5 year survival?

Answer 10

95%