Testicular Cancer Flashcards

1
Q

What is the most common presentation associated with testicular germ cell tumours?

A

painless, unilateral testicular or scrotal mass

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2
Q

Why may a patient presenting with testicular cancer have back or flank pain?

A

metastases

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3
Q

A patient with confirmed testicular cancer presents with gynaecomastia - what does this tell you about the tumour?

A

it is producing beta-hCG (which is associated with metastasis)

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4
Q

What other condition presents similarly to testicular cancer and how can you differentiate the two conditions?

A

epididymo-orchitis

differentiate using an abdominal examination - supraclavicular lymphadenopathy and a palpable abdominal mass indicates cancer

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5
Q

How often are men recommended to check their testicles for lumps?

A

every month

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6
Q

What is the most common cancer in men aged 15-35?

A

testicular cancer

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7
Q

What are the two main types of testicular germ cell tumours?

A

1) seminoma
2) non-seminoma e.g. teratomas

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8
Q

What serum tumour marker are seminomas associated with?

A

alpha fetoprotein and LDH (lactate dehydrogenase)

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9
Q

What 2 investigations can be used to confirm diagnosis of testicular cancer following examination?

A

1) ultrasound or MRI
2) serum tumour marker bloods - LDH, beta-hCG

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10
Q

How are seminomas treated?

A

radial inguinal orchidectomy followed by adjuvant chemotherapy or radiotherapy to the para-aortic lymph nodes

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11
Q

What are the two most common sites of testicular cancer metastasis?

A

1) para-aortic lymph nodes
2) lungs

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12
Q

True or false: majority of men undertaking chemotherapy for testicular cancer lose their fertility

A

False

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13
Q

are seminoma or non-semiona germ cell testicular tumours more common?

A

SEMINOMA

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14
Q

what are examples on non-germ cell testicular tumours?

A
  • leydig cell tumours
  • sarcoma
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15
Q

what is the epidemiology of testicular cancer?

A
  • seminoma = 35yrs (OLDER)
  • teratoma (non-seminoma) = 25yrs (YOUNGER)
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16
Q

what is the aetiology of testicular cancer?

A
  • <45yrs
  • caucasian males
  • infertility
  • cryptorchidism (undescended teste)
  • FH
  • Klinefelter’s syndrome
17
Q

what are the clinical features of testicular cancer?

A
  • a painless lump in the scrotum
  • gynaecomastia due to increased oestrogen:androgen ratio present with germ cell tumours
18
Q

what are the investigations for testicular cancer?

A
  • scrotal ultrasound
  • serum tumour markers = AFP, hCG and LDH
  • CT TAP for staging
  • 2 week wait
19
Q

what are the differential diagnosis for testicular cancer?

A
  • epididymal cyst
  • testicular torsion
  • epididmitis
  • hydrocele
  • variocele
  • inguinal hernia