Testicular Cancer Flashcards
What age does testicular cancer typically affect?
Younger males (15-35 y/o)
What are the 2 main histological types of testicular cancer?
Around 95% of cases of testicular cancer are germ-cell tumours. Germ cell tumours can be divided into:
1) Seminomas
2) Non-seminomatous germ cell tumours
What can non-seminomatous germ cell tumours be further classified into? (4)
1) embryonal carcinoma
2) yolk sac tumour
3) choriocarcinoma
4) teratoma (most common)
What is the most common presenting symptom of testicular cancer?
A painless testicular mass or swelling.
What are some risk factors for testicular cancer? (5)
1) Infertility (increases risk 3x)
2) Cryptorchidism
3) FH
4) Klinefelter’s syndrome
5) Mumps orchitis
Testicular cancer can be germ cell tumours or non-germ cell tumours.
What do non-germ cell tumours include?
1) Leydig cell tumours
2) Sarcomas
Clinical features of testicular cancer?
- Painless lump
- Can occasionally present with testicular pain
- Hydrocele
- Gynaecomastia
Describe the lump typically seen in testicular cancer
- Non-tender (or even reduced sensation)
- Arising from testicle
- Hard
- Irregular
- Not fluctuant
- No transillumination
Rarely, gynaecomastia (breast enlargement) can be a presentation of testicular cancer.
What type of tumour can cause this?
Leydig cell tumour
What is the 1st line investigation in testicular cancer?
Scrotal US
What are 3 tumour markers for testicular cancer?
1) AFP
2) beta-hCG
3) LDH
What type of testicular cancer is a raised AFP seen in?
Non-seminomas (most commonly teratomas)
Note - a raised AFP rules out a seminoma
What type of testicular cancer is a raised b-HCG seen in?
Seminomas & non-seminomas
What staging system is used for testicular cancer?
Royal Marsden staging system
Describe stage 1-4 of the Royal Marsden staging system for testicular cancer
Stage 1 – isolated to the testicle
Stage 2 – spread to the retroperitoneal lymph nodes
Stage 3 – spread to the lymph nodes above the diaphragm
Stage 4 – metastasised to other organs
