Testicular cancer

Question 1

RFs
Age <45
[…]
[…] syndrome
Caucasian
Previous testicular cancer
[…]
[…]

Answer 1

Infertility
Klinefelter’s
Cryptorchidism
HIV

Question 2

Types
95% of cases of testicular cancer are germ-cell tumours. Germ cell tumours may essentially be divided into:

1. Seminoma ([…]%)
2. non-seminomas: including […] (33%), embryonal, yolk sac, and choriocarcinoma
3. Mixed seminoma teratoma (12%)

Non-germ cell tumours include […] cell tumours and […].

Answer 2

55
Teratoma

Leydig, sarcomas

Question 3

Classic presentation
- […] […] lump
- […] - this occurs due to an increased oestrogen:androgen ratio

Answer 3

Painless scrotal
gynaecomastia,

Question 4

Invx
1. USS
2. Serum tumour markers
- seminomas: hCG may be elevated in around 20%
- non-seminomas: […] and/or beta-hCG are elevated in 80-85%
- […] is elevated in around 40% of germ cell tumours

Answer 4

α‎-fetoprotein (AFP), LDH

Question 5

Mx
Radical […]
Chemo + radio

Answer 5

orchidectomy