Testicular Cancer

Question 1

who is this common in

Answer 1

20-45 year olds (younger than other malignancies)

Question 2

risk factors

Answer 2

previous testicular cancer (contralateral)
cryptorchidism
HIV
FH

Question 3

classification

Answer 3

1. seminomatous

2. non-seminomatous

Question 4

age of seminomatous

Answer 4

35-45

Question 5

what is seminomatous responsive to?

Answer 5

radiotherapy

Question 6

appearance of seminomatous

Answer 6

potato appearance

Question 7

age of non-seminomatous

Answer 7

<35

Question 8

which class is more aggressive?

Answer 8

non-seminomatous

Question 9

what is non-seminomatous responsive to?

Answer 9

chemotherapy

Question 10

types of non-seminomatous

Answer 10

teratoma (3 germ cell layers)
yolk sac
embryonal trophoblast/ choriocarincoma

Question 11

what do most non-seminomatous produce?

Answer 11

LDH

Question 12

what does yolk sac produce

Answer 12

AFP

Question 13

what does trophoblast produce?

Answer 13

beta-HCG

Question 14

where do normal testis make sperm

Answer 14

seminiferous tubule

Question 15

what do seminiferous tubules contain?

Answer 15

germ cells
sertoli cells
maturing sperm

Question 16

what does the interstitium of the testes contain?

Answer 16

leydig cells

Question 17

what do leydig cells produce?

Answer 17

DHEA that is converted to testosterone

Question 18

benign lump causes

Answer 18

hernia
cystocele
hydrocele
spermatocele (cystic change in vas)
varicocele

Question 19

presentation of varicocele

Answer 19

varicosities of venous plexus

bag of worms on palpation

Question 20

presentation of testicular cancer

Answer 20

scrotal lump
pain due to bleeding
if advanced= weight loss, neck lumps, chest symptoms, bone pain

Question 21

diagnosis

Answer 21

mass, hydrocele
USS CT
bloods for serum tumour markers

Question 22

management

Answer 22

radical inguinal orchidectomy (sperm preservation)
follow up (chemotherapy as adjuvant)