Testicular Cancer

Question 1

how is cause of testicular/scrotal lump imaged?

Answer 1

US

Question 2

examination features of testicular cancer?

Answer 2

non-tender (or even reduced sensation)
lump arising from testicle (doent really move?)
irregular shape
hard lump
lump doesnt fluctuate

Question 3

does testicular cancer transluminate?

Answer 3

no

Question 4

what age does testicular cancer generally occur in?

Answer 4

15-40

Question 5

what is a hydrocele?

Answer 5

build-up of fluid within tunica vaginalis

Question 6

examination features of hydrocele?

Answer 6

soft, fluctuating swelling
can be large swelling
irreducible swelling (ie not a hernia)

Question 7

does a hydrocele transilluminate?

Answer 7

yes

Question 8

what is a variocele?

Answer 8

swollen pampiniform venous plexus (testicular veins)

Question 9

examination features of variocele?

Answer 9

soft “bag of worms”

can cause dragging or soreness

Question 10

what can a variocele indicate?

Answer 10

usually harmless

Question 11

examination features of a epididymal cyst?

Answer 11

soft, fluctuant lump at the top of the testicle

usually asymptomatic and present after feeling lump on self examination

Question 12

what causes an epididymal cyst/spermatocele?

Answer 12

usually harmless

no real cause

Question 13

examination features of epididymo-orchitis?

Answer 13

tender
generally swollen
often have fever and feeling unwell

Question 14

examination features of inguinal hernia?

Answer 14

lump separate from testicle 
cant get above the lump
soft
can often hear bowel sounds
can be reducible depending on type

Question 15

examination features of testicular torsion?

Answer 15

extremely painful
abnormal lie (eg affected testicle laying sideways)
one testicle sitting higher then the other

Question 16

where to testicular veins drain into?

Answer 16

right testicular vein drains into IVC

left testicular vein drains into left renal vein

Question 17

how can renal pathology cause variocele?

Answer 17

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

Question 18

types of testicular cancer (germ cell cancers)?

Answer 18

seminoma
teratoma
rarely other types

Question 19

what tumour markers can be raised in testicular cancer?

Answer 19

AFP
bHCG
LDH

Question 20

when is AFP raised?

Answer 20

teratoma??

yolk sac tumour (type of non-seminoma)

Question 21

when is bHCG raised?

Answer 21

teratoma or seminoma but usually in teratoma

in trophoblast tumour (type of non-seminoma)

Question 22

where can testicular cancers metastasise?

Answer 22

lymph nodes (para-aortic)
lungs
liver
brain

Question 23

prognosis of testicular cancer?

Answer 23

generally good unless metastatic (90% cure rate)

even metastases is curable though

Question 24

management of testicular cancer?

Answer 24

chemotherapy/radiotherapy based on staging
orchidectomy
monitor tumour markers and do imaging post treatment

Question 25

risk factors for seminoma?

Answer 25

undescended testes

Question 26

difference between spermatocele and epididymal cyst?

Answer 26

same really but spermatocele contains sperm cells as well as fluid

Question 27

what predisposes to testicular torsion?

Answer 27

bell clapper deformity

tunica vaginalis inserts too high meaning testicle is free to rotate more

Question 28

which type of testicular cancer usually affects slightly older men (40s)?

Answer 28

seminoma

Question 29

how are seminomas managed?

Answer 29

very sensitive to radiotherapy

Question 30

which testicular cancer is more aggressive?

Answer 30

non-seminoma

Question 31

what age does teratoma occur in?

Answer 31

around 30

Question 32

how is non-seminoma testicular cancer managed?

Answer 32

chemotherapy