Testicular Cancer/Lumps

Question 1

What are the common tumour markers for testicular cancer?

Answer 1

AFP - present in yolk sac tumours
b-hCG - (same as what is tested in pregnancy tests) - present in trophoblast
Lactase dehydronase

Question 2

What is the first investigation?

Answer 2

USS

Question 3

How would testicular cancer present?

Answer 3

Scrotal lump
NON-tender
Irregular

Question 4

Does a history of undescended testicles put up at an increased or decreased risk of testicular cancer?

Answer 4

Increased

Question 5

What are the two types of germ cell derived tumours?

What type is more aggresive?

Answer 5

Seminomas - most common

NSGCT - non seminomatous germ cell tumour
- more aggressive

Question 6

What is the first line management of testicular cancer?

Answer 6

Radical orchidectomy - can preserve sperm

Question 7

Where are the lymph nodes for testicular cancer spread?

Answer 7

Para-aortic/lumbar

Question 8

What is a hydrocele?

Is it trans-illuminable?

Answer 8

Fluid between tunica vaginalisis

Yes

Question 9

What is a spermatocele?

Answer 9

Cystic change within the epididymis

Question 10

What is a varicocele?

Answer 10

Varicostities of the venous plexus (pampiniform plexus) that drains the testes

Question 11

What in the testes feels like ‘bag of worms’?

Answer 11

Varicocele

Question 12

How does seminoma cancer respond to RADIO?

Answer 12

V well - v good prognosis

Question 13

How is mets in NSGCT managed?

Answer 13

Chemo

Question 14

What is the most common type in those <4yo?

Answer 14

Yolk sac NSGCT

Question 15

How should a variocele be investigated?

Answer 15

USS

Question 16

Blue dot sign

Answer 16

Torted hydatid of Morgagni

Question 17

What causes epididymo-orchitis?

Answer 17

Infection

Question 18

What is a left variocele associted with?

Answer 18

Left renal malignancy - CT KUB to rule it out is required