Testicular Tumors

Question 1

What percentage of male neoplasms are testicular cancers?

Answer 1

1-1.5%

Question 2

Which age group is most affected by testicular cancer?

Answer 2

18 to 35 years

Question 3

What is a common genetic alteration in testicular cancer?

Answer 3

Chromosome 12 abnormality

Question 4

What condition involves undescended testes?

Answer 4

Cryptorchidism

Question 5

What percentage of testicular tumors are germ cell neoplasms?

Answer 5

0.95

Question 6

What is the most common type of germ cell tumor?

Answer 6

Seminoma

Question 7

What are the three subtypes of seminoma?

Answer 7

Typical, anaplastic, spermatocytic

Question 8

Which germ cell tumors are most aggressive?

Answer 8

Choriocarcinoma and yolk sac tumors

Question 9

Which serum marker is produced by yolk sac tumors?

Answer 9

Alpha fetoprotein (AFP)

Question 10

Which serum marker is produced by trophoblasts?

Answer 10

Beta-HCG

Question 11

What is the role of LDH in testicular tumors?

Answer 11

Index of tumor volume

Question 12

What is the standard initial imaging modality for testicular cancer?

Answer 12

Scrotal ultrasound

Question 13

What is the first physical sign often noticed in testicular cancer?

Answer 13

Painless, hard scrotal mass

Question 14

What is the surgical approach for diagnosing testicular tumors?

Answer 14

Inguinal exploratory surgery/orchidectomy

Question 15

Why is scrotal incision avoided in testicular tumor surgery?

Answer 15

To prevent lymphatic dissemination

Question 16

What can be placed after orchidectomy for cosmetic purposes?

Answer 16

Silicone testicular prosthesis

Question 17

What is testis-sparing surgery?

Answer 17

Removal of only the lesion in select cases

Question 18

What is TIN in testicular pathology?

Answer 18

Testicular intraepithelial neoplasia

Question 19

What is the most common site of lymphatic spread?

Answer 19

Retroperitoneal lymph nodes

Question 20

What imaging is used for staging testicular tumors?

Answer 20

Contrast-enhanced CT of thorax and abdomen

Question 21

When is a brain CT or bone scan indicated?

Answer 21

In patients with neurological symptoms or skeletal pain

Question 22

What staging system is used for testicular tumors?

Answer 22

TNM classification (UICC)

Question 23

What prognostic system is used in testicular cancer?

Answer 23

IGCCCG classification

Question 24

What are the three IGCCCG prognosis groups?

Answer 24

Good, Intermediate, Poor

Question 25

What fertility option is recommended before treatment?

Answer 25

Sperm cryopreservation

Question 26

What are treatment options for Stage I seminoma?

Answer 26

Surveillance, chemotherapy, radiotherapy, RPLND

Question 27

What chemotherapy is used in Stage I seminoma?

Answer 27

Carboplatin (1–2 cycles)

Question 28

What are risk factors for Stage I seminoma relapse?

Answer 28

Tumor size >4 cm, rete testis invasion

Question 29

What are treatment options for Stage I NSGCT?

Answer 29

Surveillance, BEP chemotherapy, RPLND

Question 30

What does BEP stand for?

Answer 30

Bleomycin, Etoposide, and Cisplatin

Question 31

What are risk factors for Stage I NSGCT relapse?

Answer 31

Vascular invasion, >70% proliferation, >50% embryonal component

Question 32

What is standard treatment for Stage IIA/B seminoma?

Answer 32

Radiotherapy or BEP chemotherapy

Question 33

What is the relapse rate for Stage IIA/B seminoma post-radiation?

Answer 33

9–24%

Question 34

What is the standard treatment for Stage IIA/B NSGCT?

Answer 34

Chemotherapy

Question 35

What is given for good prognosis metastatic seminoma?

Answer 35

3 cycles of BEP or 4 of EP

Question 36

What is a residual tumor resection?

Answer 36

Surgical removal of tumor mass post-chemotherapy

Question 37

When is PET scan recommended in seminoma?

Answer 37

For masses >3 cm post-treatment

Question 38

What defines a poor prognosis NSGCT?

Answer 38

Non-pulmonary metastases or very high tumor markers

Question 39

What surgical technique may follow BEP in NSGCT?

Answer 39

RPLND (Retroperitoneal lymph node dissection)

Question 40

What minimally invasive options exist for RPLND?

Answer 40

Laparoscopic or robotic surgery

Question 41

What testicular tumor type may respond to radiotherapy?

Answer 41

Seminoma

Question 42

Which tumor marker is not elevated in pure seminoma?

Answer 42

AFP

Question 43

Where do testicular tumors rarely metastasize early?

Answer 43

Inguinal lymph nodes

Question 44

What is the advantage of early CT over X-ray in staging?

Answer 44

Higher sensitivity for metastasis

Question 45

What does a hypoechoic lesion on ultrasound suggest?

Answer 45

Possible testicular tumor

Question 46

Why is the spermatic cord removed in orchidectomy?

Answer 46

For proper staging and margin control

Question 47

What is the significance of vascular invasion in pathology?

Answer 47

Indicates higher relapse risk

Question 48

What is done if tumor markers don’t drop post-orchidectomy?

Answer 48

Consider residual or metastatic disease

Question 49

What is orchiepididymitis?

Answer 49

Inflammation of testis and epididymis, mimicking tumor