Testicular tumours

Question 1

How can we divide germ cell tumours?

Answer 1

Germ cell tumours may be divided into:

• seminomas
• non-seminomas: including embryonal, yolk sac, teratoma and choriocarcinoma

Question 2

What tumour marker is sensitive for seminomas?

Answer 2

Placental ALP

Question 3

What tumour marker is sensitive for seminomas?

Answer 3

ALP

b-HCG

Question 4

Commonest route of spread of seminomas

Answer 4

lymphatics

para-aortic nodes

Question 5

Commonest route of spread of teratomas

Answer 5

Blood

Question 6

How do we stage testicular cancers?

Answer 6

The Royal Marsden Classification can be used in the staging of the testicular cancer

Stage I - Disease confined to testes
Stage II- Infra-diaphragmatic lymph node involvement
Stage III- Supra- and infra-diaphragmatic lymph node involvement
Stage IV- Extralymphatic metastatic spread

Question 7

What does inguinal radical orchidectomy involve?

Answer 7

Removes of testes and spermatic cord, allowing for maximal lymphatic system to be removed

Question 8

What are the clinical features?

Answer 8

Patients will present with a unilateral painless testicular lump. On examination*, the mass is typically irregular, firm, fixed, and does not transilluminate.

Question 9

First line Ix

Answer 9

USS