Testicular Cancer Flashcards
(26 cards)
What is the most common presentation associated with testicular germ cell tumours?
painless, unilateral testicular or scrotal mass
Why may a patient presenting with testicular cancer have back or flank pain?
metastases
A patient with confirmed testicular cancer presents with gynaecomastia - what does this tell you about the tumour?
it is producing beta-hCG (which is associated with metastasis)
What other condition presents similarly to testicular cancer and how can you differentiate the two conditions?
epididymo-orchitis
differentiate using an abdominal examination - supraclavicular lymphadenopathy and a palpable abdominal mass indicates cancer
How often are men recommended to check their testicles for lumps?
every month
What is the most common cancer in men aged 15-35?
testicular cancer
What are the two main types of testicular germ cell tumours?
1) seminoma
2) non-seminoma e.g. teratomas
What serum tumour marker are seminomas associated with?
alpha fetoprotein and LDH (lactate dehydrogenase)
What 2 investigations can be used to confirm diagnosis of testicular cancer following examination?
1) ultrasound or MRI
2) serum tumour marker bloods - LDH, beta-hCG
How are seminomas treated?
radial inguinal orchidectomy followed by adjuvant chemotherapy or radiotherapy to the para-aortic lymph nodes
What are the two most common sites of testicular cancer metastasis?
1) para-aortic lymph nodes
2) lungs
True or false: majority of men undertaking chemotherapy for testicular cancer lose their fertility
False
are seminoma or non-semiona germ cell testicular tumours more common?
SEMINOMA
what are examples on non-germ cell testicular tumours?
- leydig cell tumours
- sarcoma
what is the epidemiology of testicular cancer?
- seminoma = 35yrs (OLDER)
- teratoma (non-seminoma) = 25yrs (YOUNGER)
what is the aetiology of testicular cancer?
- <45yrs
- caucasian males
- infertility
- cryptorchidism (undescended teste)
- FH
- Klinefelter’s syndrome
what are the clinical features of testicular cancer?
- a painless lump in the scrotum
- gynaecomastia due to increased oestrogen:androgen ratio present with germ cell tumours
what are the investigations for testicular cancer?
- scrotal ultrasound
- serum tumour markers = AFP, hCG and LDH
- CT TAP for staging
- 2 week wait
what are the differential diagnosis for testicular cancer?
- epididymal cyst
- testicular torsion
- epididmitis
- hydrocele
- variocele
- inguinal hernia
What are 4 risk factors for testicular cancer?
- Undescended testes
- Male infertility
- Family history
- Increased height
What is the typical presentation of testicular cancer?
Painless lump on testicle
Clinical features include:
Non-tender (or even reduced sensation)
Arising from testicle
Hard
Irregular
Not fluctuant
No transillumination
Which type of tumour can gynaecomastia be a sign of?
Leydig tumour
What is the staging system of testicular cancer?
Royal Marsden Staging System
What are the 4 stages of the Royal Marsden staging system?
Stage 1 – isolated to the testicle
Stage 2 – spread to the retroperitoneal lymph nodes
Stage 3 – spread to the lymph nodes above the diaphragm
Stage 4 – metastasised to other organs
