neo_testicular
Table of Contents
testicular tumours
Introduction
- onset most commonly occurs in males 20 to 34 years old, rarely before 15 years old
- most are now highly treatable and usually curable even if spread has occurred
- more than 95% of testicular cancers are germ cell tumors (GCTs), for example:
- seminoma 36%
- teratoma 7%
- germ cell neoplasia in situ
- gonadoblastoma
- embryonal carcinoma 4%
- yolk sac tumour 8%
- choriocarcinoma
- trophoblastic tumours
- mixed germ cell tumours 28%
- most of the remaining 5% are sex cord–gonadal stromal tumours derived from Leydig cells or Sertoli cells eg:
- Leydig cell tumour
- Sertoli cell tumour 2%
- granulosa cell tumours
- thecoma
- fibroma
- stromal tumours
- in addition, lymphoma accounts for 8% of scrotal tumours while leukaemia causes 3%
Risk factors
-
- testicular dysgenesis syndrome:
- cryptorchidism
- hypospadias
- poor semen quality
- testicular cancer
- family history of testicular cancer
- past history of testicular cancer
- inguinal herniae
- Klinefelter syndrome
- mumps orchitis
- sedentary lifestyle
- early onset of male characteristics
Diagnostic workup in ED
- ultrasound
- tumour markers:
- alpha-fetoprotein
- human chorionic gonadotropin (hCG) - raised in 25% of seminomas
- LDH-1
Usual Rx
- orchidectomy of the affected testis
- adjuvant chemotherapy
- usually platinum-based drugs like cisplatin and carboplatin
- radiotherapy may be used to treat stage II seminoma cancers but is ineffective for non-seminoma tumours
neo_testicular.txt · Last modified: 2025/01/10 05:45 by gary1