Testis pathology

Question 1

Types of testis cancer

Answer 1

Germ cell: seminoma, non-seminomatous germ cell tumour 
Leydig cell (in kleinfelters)

Question 2

Tumour markers in testis cancer

Answer 2

Alpha fetoprotein: only raised in NSGCT
Beta-HCG: raised in 10% seminomas
LDH indicates tumour bulk

Question 3

Management of testicular cancer

Answer 3

Sperm banking if <55
Orchidectomy
LN dissection if applicable
Chemo if mets (cisplatin?)

Question 4

How to diagnose and stage testicular cancer

Answer 4

Diagnose with USS

Stage with CTCAP

Question 5

History in testicular torsion

Answer 5

Sudden onset
Severe pain
Unilateral
Radiates to groin, iliac fossa and flank
N and V
No LUTS

Question 6

Examination findings in testicular torsion

Answer 6

Erythematous scrotum
Very tender testis - can’t examine
Transverse lie of opposite testicle

Question 7

Management for testicular torsion

Answer 7

Surgical exploration - no time for Ix
Orchidectomy if prolonged ischaemia
Prophylactic bilateral orchidopexy to prevent torsion on other side

Question 8

How to insert testis prosthesis

Answer 8

Through inguinal canal