testis cancer

Question 1

what are the clinical features of testis cancer?

Answer 1

• age 15-45 (less common in older men)
• majority are germ cell tumours
• usually notice a lump
• firm, fixed mass on examination
• can present with systemic symptoms if mets extensive
• solid mass inseparable from testis in clinical exam
• USS is key diagnostic test plus CT CAP for staging

Question 2

what are the two types of germ cell tumours?

Answer 2

either
non seminomatous germ cell tumours
or
seminoma

Question 3

what are the tumour markers in testis cancer?

Answer 3

• Alpha fetoprotein specific to non seminoma
• Beta HCG raised in non seminoma
• LDH is a marker of tumour bulk

Question 4

what is the treatment for tests cancer?

Answer 4

• good survival rate at 98% at 5 years
• radical inguinal orchidectomy (sperm bank offered to under 55)
• chemo for metastatic disease
• retroperitoneal lymph node dissection used for residual
  non seminomas masses after chemo
• radiotherapy can be used for lymph nodes but is rare

Question 5

what are the categories of germ cell tumours?

Answer 5

Primary testicular tumours are categorised into germ cell tumours (GCT) (95%)
and non-germ cell tumours (NGCTs) (5%);

GCTs can be further sub-classified into seminomas and non-seminomatous GCTs (NSGCT), and are usually malignant.

Question 6

what type of testicular tumour is common per age group?

Answer 6

20-45 = most likely to get them

20-35 = tetroma’s (tumour marker AFP)

35-40 = seminomas more common