Urology - Testicular Tumours

Question 1

Testicular tumours: epidemiology

Answer 1

-Commonest male malignancies form 15-44years

Question 2

Testicular tumours: presentation

Answer 2

• Painless testicular lump (often noticed after trauma)
• haematospermia
• Secondary hydrocele
• Mets: SOB from lung mets
• Abdo-mass: para-aortic lymphadenopathy
• Hormones: gynaecomastia, virilisation
• contralateral tumour in 5%

Question 3

Risk factors

Answer 3

• Undescended testes (occurs in 10% of undescended tested)
• Infant hernia
• infertility

Question 4

Pathology: Germ cell - pure seminomas

Answer 4

• Germ cell tumours: 95% of tumours
• Pure seminomas are germ cell tumours (40%) (commonest single subtype)
• 30-40 years
• raised beta HCG in 15%
• raised placental ALP in some
• very radiosensitive

Question 5

Testicular tumours: Germ cell - Non senimomas (inc mixed)

Answer 5

• Non seminomas are 60% of germ cell tumours
• Teratoma: arise from all 3 germ layers, commonest and benign in children, rare and malignant in adults.
• secrete beta HCG or AFP
• chemosensitive

Question 6

Testicular tumours: Non seminomas - mixed

Answer 6

• Commonest of all non-seminomas germ cell tumours

- weird mix of cells

Question 7

Testicular tumours: non-seminomas: Yolk sac

Answer 7

• commonest testicular tumour in children

- raised AFP