Testicular Cancer

Question 1

who does testicular cancer commonly affect

Answer 1

young males

Question 2

what is the prognosis for testicular cancer

Answer 2

highly curable when diagnosed earlier

Question 3

what is a precancerous condition for testicular cancer

Answer 3

carcinoma in situ

Question 4

aetiology

Answer 4

all germ cell tumours begin during fetal development and progress through a non-invasive stage called intratubular germ cell neoplasia (carcinoma in situ)

Question 5

what is carcinoma in situ

Answer 5

a precancerous lesion which may lead to malignant growth

Question 6

what environmental factors can cause testicular cancer

Answer 6

trauma
hormones
atrophy

Question 7

what chromosomal factors can induce testicular cancer

Answer 7

gain of 12p

Question 8

how does carcinoma in situ become testicular cancer

Answer 8

malignant transformation of carcinoma in situ by growth beyond basement membrane

Question 9

how does metastasis occur in testicular cancer

Answer 9

lymphatics

Question 10

what is the most common form of germ cell testicular cancer

Answer 10

seminoma

Question 11

risk factors

Answer 11

cryptochidism (absence of testes - undescended testis)
FHx or PMHx of testicular cancer
testicular atrophy due to trauma

Question 12

what are features of testicular cancer

Answer 12

RFs
young adult male
painless testicular mass which is smooth and firm

Question 13

what should be done first when a patient presents with suspected testicular cancer

Answer 13

examination

Question 14

what is the first line investigation for testicular cancer

Answer 14

USS (colour doppler)

Question 15

what can doppler differentiate testicular cancer from

Answer 15

varicocele

Question 16

what is diagnostic of testicular cancer (tumour markers)

Answer 16

raised B-hCG, AFP, LDH

Question 17

which carcinomas are not associated with a rise in AFP (b-hCG only)

Answer 17

seminomas

choriocarcinomas

Question 18

what are two groups of testicular cancers

Answer 18

1 germ cell TCs

2 sex-cord stromal TCs

Question 19

what are the different forms of germ cell TCs

Answer 19

A seminoma

B embryonal carcinoma

Question 20

what are the different forms of embryonal carcinomas

Answer 20

1 extraembryonic tissues
-choriocarcinoma
-endodermal sinus tumour
2 embryonic tissues
-teratoma
3 mixed
-teratocarcinomas

Question 21

what are the different forms of sex-cord stromal TCs

Answer 21

A sertoli cell tumour
B leydig cell tumour
C lymphoma
D SCC

Question 22

is a seminoma radio or chemo sensitive

Answer 22

both

Question 23

what tumour marker is associated with seminoma

Answer 23

placental alkaline phosphatase (PLAP)

Question 24

when can PLAP not be used as a marker for seminoma

Answer 24

in smokers - interferes with PLAP levels

Question 25

what condition are seminomas associated with

Answer 25

cryptorchidism

Question 26

are embryonal carcinomas radio or chemo sensitive

Answer 26

chemo sensitive (choriocarcinoma, endodermal sinus tumour, teratomas, teratocarcinomas)

Question 27

what tumour marker is associated with choriocarcinoma

Answer 27

BcHG

Question 28

what tumour marker is associated with endodermal sinus tumour

Answer 28

AFP

Question 29

is teratoma benign or malignant

Answer 29

malignant

Question 30

who presents with SCC of testicles

Answer 30

those exposed to soot (chimney sweeps)

Question 31

what is the most common sex cord stromal TC

Answer 31

lyphoma

Question 32

who presents with lymphomas

Answer 32

>60yrs

Question 33

who presents with leydig cell tumours

Answer 33

<60yrs

Question 34

what is seen in children and adults with leydig cell tumorus

Answer 34

precocious puberty in children | gynaecomastic in adults