Testicular Cancer

Question 1

GCT classification

Answer 1

Seminoma
Non seminomatous GCT: teratoma, teratocarcinoma, embryonal ca, choriocarcinoma, yolk sac tumor
Mixed
Non GCT (rare) lymphoma, leydig or sertoli cel tumor

Question 2

Tumor markers

Answer 2

Specific:
Beta HCG, pro by trophoblastic element in NSGCT half life 24hrs
AFP: produced by yolk sac element of NSGCT half life 5days

Non-specific
LDH: just gives an indi of tumor burden. The more advanced the tumor the higher the LDH

NB‼️ can stage on tumor markers and whether they decrease post orchidectomy

Question 3

Ddx for mass in scrotum

NB‼️ a solid mass in scrotum = testis tumor until proven otherwise

Answer 3

Acute epididymitis
Missed torsion
Paratesticular tumor (gen sarcoma from spermatic cord)
TB epididymitis 
Granulomatous orchitis

Question 4

Testicular cancer aka Germ Cell Tumor GCT etiology

Answer 4

Undescended testis~10% and incidence higher when UDT was intra-abdo
Atrophy of testis. Post mumps orchitis
Infertility
CIS in testis: leads to GCT in 5O% of cases by 5 years
Intersex pts