Urology: testicular cancer Flashcards
Name a tumour marker you may ask for, for suspected testicular cancer
HCG, AFP, LDH (less specific)
Name a presenting feature of testicular cancer that is not found in the testis/scrotal area.
Gynaecomastia
How does testicular cancer present?
Typically painless
Non tender
Arise from testes
Hard
Irregular
No fluctuation
No transillumination
V rare = gynaecomastia (often in rare ones like Leydig cell tumours)
Who most commonly has testicualr cancer?
age 20-40
What are RF for testicular cancer?
Undescended testes, FHx, being tall, male infertility, Klinefelter’s syndrome, HIV/AIDS
Which type of cell do testicular cancers most likely arise from?
germ cells.
What are the two germ cell tumour groups?
Seminoma and non-seminoma
What is felt on examination of testis with testicular cancer?
No transillumination, hard, irregular, no fluctuation.
Name some investigations for suspected testicular cancer
Initial investigation : Ultrasound definitive to diagnose
Tumour markers:
Alpha-fetoprotein (raised in teratomas)
Beta-hCG (raised in teratomas and seminomas)
lactate dehydrogenase (non specific tumour marker
Staging
A Staging CT- spread / stage
Royal Marsden Staging system
1) isolated to testes
2) Regional lymph node invovlement
3) Diagphram lymph node
4) mets to other organs
Common mets: Lymphatics, Lungs, Liver, Brain
How is testicular cancer managed by surgery?
Radical orchidectomy - curative if not spread yet.
What are ddx for testicular cancer?
Hydrocele, epididymal cyst.
What is the Royal Marsden Staging system?
Testicular Cancer:
1) isolated to testes
2) Regional lymph node invovlement
3) Diagphram lymph node
4) mets to other organs
What are common mets for testicular cancer?
Common mets: Lymphatics, Lungs, Liver, Brain
Risk factors for testicular cancer?
Family history
Klienefelters syndrome
Infertility
Cryptochism
Mumps orchitis
