testicular cancer Flashcards

1
Q

arises from

A

germ cells in testes

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2
Q

most common in

A

younger men - peak incidence 15-35yrs

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3
Q

two types

A

seminomas

non-seminomas (mostly teratomas)

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4
Q

risk factors

A

undescended testes
male infertility
FHx
increased height

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5
Q

typical presentation

A

painless testicular lump

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6
Q

OE - lump will be

A
non-tender
arising from testicle
hard
irregular
non-fluctuant
no transillumination
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7
Q

gynaecomastia and testicular cancer

A

rarely gynaecomastia can be presentation of testicular cancer

esp leydig tumour

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8
Q

Ix

A

scrotal USS initial Ix

tumour markers
staging CT

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9
Q

tumour markers

A

alpha-fetoprotein (teratomas)
beta-hCG
LDH

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10
Q

staging system

A

royal marsden staging system

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11
Q

stage 1

A

isolated to testicle

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12
Q

stage 2

A

retroperitoneal nodes

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13
Q

stage 3

A

nodes above diaphragm

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14
Q

stage 4

A

metastases to other organs

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15
Q

common places for metastases

A

lymphatics
lung
liver
brain

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16
Q

Mx can involve

A

surgery - radical orchidectomy
chemotherapy
radiotherapy
sperm banking

guided by MDT

17
Q

side effects of treatment

A
infertility 
hypogonadism 
peripheral neuropathy 
hearing loss
lasting kidney, liver, heart damage
inc risk future cancer
18
Q

prognosis

A

90% cure rate

metastatic disease often curable

seminomas slightly better prognosis than non-seminomas

19
Q

follow up

A

follow up to monitor for recurrence

  • tumour markers
  • CXR, CT scans