Testicular Cancer Flashcards
1
Q
risk factors?
A
- white
- cryptorchidism
- klinefelters
2
Q
what are the 2 main types of pathology of testicular cancer?
A
- seminoma 50%
- teratoma 50%
3
Q
tumour markers?
A
- Alpha-fetoprotein may be raised in teratomas
- b-HCG may be raised in teratomas and seminomas, but more often teratomas
- lactate dehydrogenase
4
Q
What is the presentation of testicular cancer?
A
- non-tender, hard lump without fluctuance or transillumination
- irregular
less often:
- tender inflamed swelling
- symptoms/signs from nodal involvement
5
Q
epidemiology?
A
15-40 y/o
6
Q
Ix?
A
- Scrotal US
- tumour markers
NO BIOPSIES- DIAGNOSIS by excision and histology
7
Q
where is regional lymphatic spread from testicular cancer?
A
para-aortic lymph nodes
8
Q
in what circumstance would lymphatic spread reach the inguinal lymph nodes?
A
through direct invasion of the scrotal skin (skin= inguinal lymph nodes)
9
Q
most common sites of metastasis?
A
- lymphatics
- lungs
- liver
- brain
10
Q
Mx?
A
- orchidectomy
- chemotherapy / radiotherapy based on staging
- monitoring post treatment with tumour markers
11
Q
prognosis?
A
good unless metastatic
12
Q
DDx of testicular swelling?
A
13
Q
what could be the cause of a left sided unilateral varicocele?
A
left testicular vein arises from left renal vein- therefore this could indicate an obstruction of left testicular vein caused by RCC for example
