Testicular Cancer

Question 1

Define:

Answer 1

Malignant tumour of the testes

Seminomas - 50%

Non-seminomatous germ cell tumours and teratomas = 30%

Rare - gonadal stromal tumours and non-hodgkins lymphoma

Question 2

Aetiology:

Answer 2

Unknown

Question 3

Risk factors:

Answer 3

Undescended testes

Ectopic Testes

Atrophic Testes

Question 4

Epidemiology:

Answer 4

Uncommon

1% of male malignancies

Common age of onset 18-35

Question 5

Symptoms:

Answer 5

Swelling or discomfort of testes

Backache due to para-aortic lymph node enlargement

Lung metastases = SOB and haemoptysis

Question 6

Signs:

Answer 6

Painless, hard testicular mass

Secondary hydrocele

Lymphadenopathy (para-ortic and supraclavicular)

Gynaecomastia

Question 7

Investigations:

Answer 7

Bloods:

• FBC
• U+ES
• LFTS

Tumour markers:

• LDH
• b-HCG
• a-fetoprotein

urine pregnancy test - will be positive due to b-HCG

CXR - lung metastases

Testicular USS - see the tumour and the hydrocele

CT abdo and thorax - allows staging