Testicular cancer Flashcards
Types
Seminomas
Non-seminomas (mostly teratomas)
Risk factors
Undescended testes
Male infertility
Family history
Increased height
Klinefelter’s syndrome
Mumps orchitis
Features
Painless lump (pain in minority of men)
Hydrocele
Gynaecomastia (increased oestrogen:androgen)
Features of lump
Non-tender
Arising from testicle
Hard
Irregular
Non-fluctuant
No transillumination
Investigations
Scrotal US is initial investigation
Tumour markers
Staging CT
Tumour markers
Alpha-fetoprotein: raised in teratomas (not pure seminomas)
Beta-hCG: raised in both teratomas and seminomas
LDH: very non-specific tumour marker
Royal marsden staging system
1: isolated to testicle
2: spread to retroperitoneal lymph nodes
3: spread to lymph nodes above the diaphragm
4: metastasised to other others
Common places for testicular cancer to metastasise to
Lymphatics
Lungs
Liver
Brain
Management
Surgery to remove affected testicle
Chemotherapy
Radiotherapy
Sperm banking
Follow up (monitor tumour markers and CT scans/ chest xrays)
Prognosis
5 year survival 95% for seminomas if stage 1
5 year survival 85% for teratomas if stage 1
