Testicular Tumors Flashcards
What are the 2 main types of testicular tumors?
germ cell: seminoma, nonseminoma
stromal tumors: leydig, sertoli, granulosa
Risk factors for testicular tumors?
Cryptorchidism
Family History
Personal history
HIV Infection
What are common misconceptions that are actually not risk factors for testicular tumors?
Diethylstilbestrol exposure in utero
Testicular atropy
Trauma
Presentation for testicular tumors?
painless mass/swelling in testicle
R >L
back pain or abd mass
Where can testicular tumors metastasis to?
bilateral testis tumor
retroperitoneal lymph nodes
distant organs
How should you eval for testicular tumors?
US
tumor markers: AFP, beta HCG, LDH
LFTs, CBC, Cr
CXR
Tx for testicular tumors?
lymphoma: refer to onc.
radical orchiectomy: sperm banking, inguinal, testis sparing +/- prosthesis
How is Radical inguinal orchiectomy performed?
Outpatient
Scrotal compression
Ice pack, elevation, po analgesics
What should you check post oirchiectomy?
after 5 half lives:
AFP: 5 weeks
B-HCG: 1-2 weeks
LDH: 3 weeks
CT Chest/Abd/Pelvis
How are testicular tumors staged?
TNM
Tumor: Tx through T4
Lymph Nodes: Nx through N3
Distant Metastasis: M0 through M1b
Monitoring guidelines post orchiectomy?
H&P, tumor markers q 3-4 mo x 2yr
H&P, tumor markers q 6-12 mo x 2yr
then annually
imaging: CT q 6 months x 2 yrs, then annually x 2 yrs
CXR PRN
Other possible therapy post orchiectomy?
chemo
radiation
lymph node dissection
px for testicular tumors
generally good
