Testicular Cancer Flashcards
RFs for Testicular Ca?
Contralateral Testicular Tumour
Cryptorchidism
Poor Semen Analysis
TEsticular Tumour amongst 1st Degree Relatives
Significance of Testicular Microlithiasis
Higher risk of testis cancer when other RFs present
- Surveillance +/-Biopsy
Testicular Tumour Markers:
AFP
Non-Seminomatous Germ cell Tumours
(50-70% Sensitivity)
Testicular Tumour Markers:
B HCG
Non Seminomatous Germ Cell Tumours:
40-60% Sensitvity
List all Testicular Tumour Markers
AFP
BHCG
LDH
Carinoembyronic Antigen (CEA)
Neuron Specific Enolase (NSE)
What are pre-op essenitals in Testicular Ca
Sperm Banking
Tumour Markers
Testicular Prosthesis Counselling
Considering contralateral testis biopsy
Staging CT can be considered but usually post op
Why perform Contralateral Biopsy?
TIN Rate 5%
Where TIN Present - Cancer present in 40% of cases
Risk of progression of TIN
Invasive testis tumour develops in 70% of patients with TIN in 7 years
When to perform CL testis biopsy
Age 40 + Testicular volume <12 ml - >34% chance of TIN
Extragonodal Germ Cell Tumour - 10% change of TIN
Rx for TIN?
Surveillance versus radiotherapy
Non Seminomatous Germ Cell Tumour Risk of Recurrence
Low Risk ( No Vascular Invasion ) - 20% relapse with Orchidectomy alone
High Risk ( VI Present) - 50% relapse
30% G1 NSGCT have subclinical metastases
Why viral screen when sperm banking?
Important for sperm banking site to know for logistical purposes
Ultrasound features of testicular tumour?
Hyperechoic, hypervascular, Size, Scrotal Wall Invasion
Which patients need neoadjuvant chemotherapy?
Heavy burden of metastatic disease
Sperm Banking:
Absolute indications for pre-op
Abnormal Semen Analysis, Bilateral Tumours, Abnormal Contralateral Testis
