Testicular Cancer Flashcards
What are the risk factors for testicular cancer?
- Under age 45,
- Caucasian ethnicity,
- Previous history of testicular cancer
- Cryptorchidism
- HIV
- Infertility
- Mumps orchitis
- Increased height
What are the histological subtypes of testicular cancer?
- Seminoma (55%)
- Non-seminoma’s eg, teratoma
What are the signs and symptoms of testicular cancer?
- Painless lump (most commonly but can have pain)
- Hydrocoele,
- Gynecomastia (Germ cell tumours secrete hCG or leydig tumour)
What are some tumour markers for testicular cancer?
Seminomas - hCG
Non-seminomas - AFP and/or beta hCG
LDH
AFP - Teratomas
bhCG - Seminoma and teratomaa
LDH - non specific
What are the differential diagnosis for testicular cancer?
- Epididymal cyst,
- Testicular torsion,
- Epididymitis,
- Hydrocoele,
- Varicocele
- Inguinal hernia
What are the investigations for testicular cancer?
- History and examination, specifically family history.
- Scrotal ultrasound
- Tumour markers
- CT CAP for staging
What is the management of testicular cancer?
- Radical orchidectomy,
- Radiotherapy
- Chemotherapy (adjuvant)
What are some of the complications of testicular cancer?
Infertility,
Hypogonadism
Treatment related: nausea, neutropenia, pulmonary toxicity, kidney injury, hearing loss,
Mets
What lymph nodes drain the testicles?
Para-aortic
What is the prognosis for stage I testicular cancer?
5 year survival of 95% for seminoma and 85% for teratomas
Where are the common areas for testicular cancer to spread to?
- Brain, lungs, liver and lymphatics
