Testicular Cancer

Question 1

Define testicular cancer

Answer 1

Malignant tumour of the testes
Germ cell tumours (90-95%) – semimoma and teratoma
Non-germ cell tumours (5-10%)

Question 2

What are the causes/risk factors of testicular cancer?

Answer 2

• Cryptorchidism
• Gonadal dysgenesis
• Family history

Question 3

What are the signs and symptoms of testicular cancer?

Answer 3

• Hard painless mass
• Heaviness in scrotum
• Pain (10%)
• Bone pain
• Gynaecomastia

Question 4

What investigations are carried out for testicular cancer?

Answer 4

• Bloods - FBC, U&Es, LFTs (for liver mets).
• Tumour markers should be sent α-fetoprotein (this indicates teratomatous elements are present), LDH.
• Urine pregnancy test - often will be positive if the tumour produces ß-HCG.
• Testicular ultrasound - tumours seen within the testicle, a hydrocoele may be associated –diagnostic.
• CXR - demonstrates lung metastases or pleural effusion.
• CT scan (abdomen, thorax) - for disease staging. Of brain if extensive disease.