Testicular Cancer

Question 1

What are risk factors for testicular cancer?

Answer 1

Age 20-45, Caucasian, cryptorchidism, previous testicular cancer, HIV, FH

Question 2

What are the types of testicular cancer?

Answer 2

Germ cell tumours (seminoma, non-seminomatous germ cell tumour, mixed germ cell tumour), Non-germ cell tumours (lymphoma)

Question 3

What is the most common form of testicular cancer?

Answer 3

Seminoma

Question 4

What is a typical presentation?

Answer 4

A painless non-transilluminable testis lump, haemospermia

Question 5

What is the first line investigation?

Answer 5

Urgent ultrasound of testes

Question 6

What tumour markers might you look for?

Answer 6

Alpha-fetoprotein, beta-hCG, LDH

Question 7

What are the main differential diagnoses?

Answer 7

Testicular torsion, scrotal hernia, hydrocele

Question 8

What surgical option is there?

Answer 8

Urgent radical inguinal orchidectomy

Question 9

What are some common complications?

Answer 9

Treatment related nausea, treatment related neutropenia, infertility

Question 10

What is Stage I?

Answer 10

No evidence of metastasis

Question 11

What is Stage II?

Answer 11

Infradiaphragmatic node involvement

Question 12

What is Stage III?

Answer 12

Supradiaphragmatic node involvement

Question 13

What is Stage IV?

Answer 13

Lung involvement

Question 14

How would you manage metastatic disease?

Answer 14

Retroperitoneal lymph node dissection, chemo, radiotherapy