Testicular cancer Flashcards
What is the most common solid cancer in men aged 20-45?
Testicular cancer
What are the 2 main types of testicular cancer?
Seminomatous
Teratoma
What are some other types of testicular cancer?
Yolk-sac tumours
Embryonal cell carcinoma
Choriocarcinoma
Mixed germ cell tumours
What are some mixed germ cell tumours?
Sex cord stromal
Lydia cell tumours
Sertoli cell tumours
What age range most commonly gets seminomatous testicular cancer?
Ages 35-45
What age range most commonly gets non-seminomatous (Teratoma) testicular cancer?
< 35 years
What are some risk factors of testicular cancer
- White caucasian
- Previous testicular cancer
- Cryptoorchidism
- HIV
- Family history
How much does cryptorchidism increase testicular cancer risk
- Orchidopexy < 13 years old = 2x risk
- Orchidopexy > 13 years old = 5x risk
Where do seminomas form from?
Seminiferous tubules
What is the cure rate of seminoma
95% - Extremely responsive to radiotherapy even if relatively advanced
What are the characteristics of teratoma?
- Very aggressive
- Metastasise
- Usually associated with other non-seminomatous cell type cancers
Characteristics of yolk sac tumour
Can produce alpha feto-protein
Characteristics of embryonal cell carcinoma
- Aggressive
- Looks high grade
- Associated with frequent metastasis
Characteristics of choriocarcinoma
Positive for ß-HCG and positive pregnancy test
What are some symptoms of testicular cancer
- Scrotal lump
- Delayed presentation occasionally seen
- Acute pain due to bleeding
- Symptoms of advanced disease: weight loss, neck lumps, chest symptoms or bone pain
What re some signs of testicular cancer?
- Asymmetry or slight scrotal discolouration
- Hard, non-tender, irregular mass mostly intratesticular
- Assess involvement of epididymis, spermatic cord and scrotal skin
- Secondary hydrocele
- Abdominal mass, lymphadenopathy - advanced disease
What investigations are required in testicular cancer
Imaging - US testicle, CT CAP
Bloods
What blood tests are required in testicular cancer
Tumour markers
FBC
LFTs
Renal function tests
What are some tumour markers for testicular cancer
Alpha-fetoprotein - Teratomas
ß-HCG - Teratomas > Seminomas
Lactate dehydrogenase
How is testicular cancer managed?
- CT staging
- Radical inguinal orchidectomy
- 1 week post-op tumour markers
- Adjuvant chemotherapy
What are some supportive management techniques required with radical inguinal orchidectomy?
Sperm preservation
Testicular prosthesis
