Testicular Cancer

Question 1

How common are testicular tumours.

Answer 1

The most common malignancy in men aged 15-44.

Question 2

At what age can men develop testicular cancer.

Answer 2

15-44.

Question 3

What percentage of testicular cancers occur in undescended testicles.

Answer 3

10%

Question 4

In what percentage of testicular cancers is a contralateral tumour found.

Answer 4

5%

Question 5

What are the types of testicular tumours. (4)

Answer 5

Seminoma.
Non-seminomatous germ cell tumours (teratoma).
Mixed germ cell tumour.
Lymphoma.

Question 6

At what age do seminomas occur.

Answer 6

30-65 years.

Question 7

What percentage of testicular tumours are seminomas.

Answer 7

55%

Question 8

What percentage of testicular tumours are non-seminomatous germ cell tumours (teratomas).

Answer 8

33%

Question 9

At what age do non-seminomatous germ cell tumours (teratomas) tend to occur.

Answer 9

20-30years.

Question 10

What percentage of testicular tumours are mixed germ cell tumours.

Answer 10

12%

Question 11

What are the risk factors for developing testicular cancer. (3)

Answer 11

Infertility.
Infant hernias.
Undescended testis.

Question 12

What is a stage 1 testicular tumour.

Answer 12

No evidence of metastasis.

Question 13

What is a stage 2 testicular tumour.

Answer 13

Infradiaphragmatic node involvement (spread via the para-aortic nodes not the inguinal nodes).

Question 14

What is a stage 3 testicular tumour.

Answer 14

Supradiaphragmatic node involvement.

Question 15

What is a stage 4 testicular tumour.

Answer 15

Lung involvement (haematogenous).

Question 16

What are the clinical signs of testicular cancer.

Answer 16

Typically a painless testicular lump (usually found after trauma or infection).
There may be haemospermia.
Secondary hydrocele.
Pain.
Dyspnoea (if there are lung metastases).
Abdominal mass (enlarged nodes).
Effects of the hormones secreted by the tumour.

Question 17

What percentage of seminomas present with signs of metastasis.

Answer 17

25%

Question 18

What percentage of NSGCTs present with signs of metastasis.

Answer 18

50%

Question 19

What is the prevalence of testicular tumours.

Answer 19

5/100,000

Question 20

What two hormones do testicular tumours tend to secrete.

Answer 20

Beta-hCG.

AFP

Question 21

What is the least common type of testicular tumours.

Answer 21

Leydig cell tumours.

Question 22

Where do seminomas arise from.

Answer 22

Seminiferous tubules.

Question 23

How aggressive is a seminoma. (2)

Answer 23

Not very aggressive, it represents a fairly low grade malignancy, HOWEVER metastases occurs via lymphatic spread and tends to involve the lungs.

Question 24

Where do teratomas (NSGCTs) arise from.

Answer 24

Primitive germinal cells.

Question 25

How do leydig tumours present.

Answer 25

Gynacomastia.

Question 26

Why do leydig tumours present with gynacomastia.

Answer 26

They secrete oestrogen.

Question 27

What is the histology of leydig tumours. (2)

Answer 27

They tend to be small and benign.

Question 28

When do teratomas tend to occur.

Answer 28

At a young age.

Question 29

How are teratomas classified.

Answer 29

According to the degree of differentiation.

Question 30

What type of teratoma presents the best prognosis.

Answer 30

A well differentiated teratoma is not very aggressive.

Question 31

What is the first investigation when presented with a testicular lump.

Answer 31

Ultrasound.