Testicular Cancer Flashcards
how is cause of testicular/scrotal lump imaged?
US
examination features of testicular cancer?
non-tender (or even reduced sensation) lump arising from testicle (doent really move?) irregular shape hard lump lump doesnt fluctuate
does testicular cancer transluminate?
no
what age does testicular cancer generally occur in?
15-40
what is a hydrocele?
build-up of fluid within tunica vaginalis
examination features of hydrocele?
soft, fluctuating swelling
can be large swelling
irreducible swelling (ie not a hernia)
does a hydrocele transilluminate?
yes
what is a variocele?
swollen pampiniform venous plexus (testicular veins)
examination features of variocele?
soft “bag of worms”
can cause dragging or soreness
what can a variocele indicate?
usually harmless
examination features of a epididymal cyst?
soft, fluctuant lump at the top of the testicle
usually asymptomatic and present after feeling lump on self examination
what causes an epididymal cyst/spermatocele?
usually harmless
no real cause
examination features of epididymo-orchitis?
tender
generally swollen
often have fever and feeling unwell
examination features of inguinal hernia?
lump separate from testicle cant get above the lump soft can often hear bowel sounds can be reducible depending on type
examination features of testicular torsion?
extremely painful
abnormal lie (eg affected testicle laying sideways)
one testicle sitting higher then the other
where to testicular veins drain into?
right testicular vein drains into IVC
left testicular vein drains into left renal vein
how can renal pathology cause variocele?
obstruction of left renal vein (eg from renal cell carcinoma) can cause blood to back up into left testicular vein and into pampiniform plexus causing variocele
types of testicular cancer (germ cell cancers)?
seminoma
teratoma
rarely other types
what tumour markers can be raised in testicular cancer?
AFP
bHCG
LDH
when is AFP raised?
teratoma??
yolk sac tumour (type of non-seminoma)
when is bHCG raised?
teratoma or seminoma but usually in teratoma
in trophoblast tumour (type of non-seminoma)
where can testicular cancers metastasise?
lymph nodes (para-aortic)
lungs
liver
brain
prognosis of testicular cancer?
generally good unless metastatic (90% cure rate)
even metastases is curable though
management of testicular cancer?
chemotherapy/radiotherapy based on staging
orchidectomy
monitor tumour markers and do imaging post treatment
risk factors for seminoma?
undescended testes
difference between spermatocele and epididymal cyst?
same really but spermatocele contains sperm cells as well as fluid
what predisposes to testicular torsion?
bell clapper deformity
tunica vaginalis inserts too high meaning testicle is free to rotate more
which type of testicular cancer usually affects slightly older men (40s)?
seminoma
how are seminomas managed?
very sensitive to radiotherapy
which testicular cancer is more aggressive?
non-seminoma
what age does teratoma occur in?
around 30
how is non-seminoma testicular cancer managed?
chemotherapy
