Testicular cancer Flashcards
What age is testicular cancer most common?
20-40years
What kind of tumour are testicular tumours usually?
germ cell tumours, which are seminomas or non-seminomas
What are the risk factors for testicular cancer?
Cryptochidism (undescended testis) 4-10x higher risk of GCTs, previous testicular malignancy, a positive family history and kleinfelters syndrome
What are the clinical features of testicular cancer?
Unilateral, painless testicular lump, irregular, firm, fixes and does not transilluminate, if metastasis- weightless, back pain due to retroperitoneal metastases or dyspnoea
Will there be ly,phadenopathy with testicular cancer?
Drain to para-aortic so may not be present
What are the differentials for testicular cancer?
Epididymal cyst, haematoma, epididymitis or hydrocoele
What are the investigations for testicular cancer?
Tumour markers e.g. BHCG if NSGCTs and AFP, LDH for tumour volume
What imaging would you do for testicular cancer?
scrotal ultrasound then a CT with contrast, then a trans-scrotal percutaneous biopsy
What is testicular cancer stage I?
Disease is confined to the testis
What is testicular cancer stage II?
infra-diaphragmatic lymph node involvement
What is testicular cancer stage III?
Supra and infra- diaphragmatic lymph node involvement
What is testicular cancer stage IV?
Extralymphatic metastatic spread
What is the management for testicular cancer?
MDT, Surgery, chemotherapy and radiotherapy
What surgery would occur for testicular cancer?
inguinal radical orchidectomy
What needs to be done before testicular cancer treatment?
pre-treatment fertility assessment with a semen analysis and cyropreservation offered