Testicular Cancer
Definition
Germ cell tumour (95%)
Sex cord
Epidemiology
Most common in young men
60% seminomas (30-40y; late spread), 40% germ cell (20-30y; early spread)
Risk Factors
Clinical Features
Investigations
NOTE: No biopsy to avoid spread outside tunica albuginea
NOTE: Sentinel nodes = retroperitoneal/ para-aortic
Management
Orchidectomy
Seminoma --> radiosensitive
Non seminoma --> chemosensitive
Prognosis
Seminoma --> good
Choriocarcinoma --> most aggressive
Source
Dr Kathryn Gilliam 2014
Dr Ros Malley 2013
Germ cell tumour (95%)
- Seminoma (most common)
- Non seminoma (yolk sac (<3y), embryonal, teratoma (5%), choriocarcinoma)
Sex cord
- Leydig (secrete androgen)
- Sertoli
Epidemiology
Most common in young men
60% seminomas (30-40y; late spread), 40% germ cell (20-30y; early spread)
Risk Factors
- Undescended testicles --> seminoma
- In-utero oestrogen exposure
- Immunosuppresion
Clinical Features
- Lump
- abdo/scrotal pain
- heaviness
- gynaecomastia (bhcg)
- neck nodes
- haemoptysis
Investigations
- Both can make bhcg, only teratoma make aFP
- US (do not xray gonads)
- Urgent exploration with immediate frozen section orchidectomy
NOTE: No biopsy to avoid spread outside tunica albuginea
NOTE: Sentinel nodes = retroperitoneal/ para-aortic
Management
Orchidectomy
Seminoma --> radiosensitive
Non seminoma --> chemosensitive
Prognosis
Seminoma --> good
Choriocarcinoma --> most aggressive
Source
Dr Kathryn Gilliam 2014
Dr Ros Malley 2013