Details Descriptions About :: Testicular Cancer

 Most testicular tumors originate in gonadal cells. About 40% are seminomas—uniform, undifferentiated cells resembling primitive gonadal cells. The remainder are nonseminomas—tumor cells showing various degrees of differentiation. The prognosis varies with the cell type and disease stage. When treated with surgery and radiation, almost all patients with localized disease survive beyond 5 years. Age Alert Malignant testicular tumors primarily affect young to middle-aged men and are the most common solid tumor in these age-groups. Incidence peaks between ages 20 and 40. Testicular tumors seldom occur in children. Testicular cancer is rare in nonwhite males and accounts for fewer than 1% of male cancer deaths.

Causes for Testicular Cancer

Causes Primary cause unknown Associated conditions Cryptorchidism (even if surgically corrected) Maternal use of diethylstilbestrol during pregnancy

Pathophysiology Testicular Cancer

Pathophysiology Testicular cancer may metastasize to the lungs, liver, viscera, or bone. It spreads through the lymphatic system to the iliac, para-aortic, and mediastinal lymph nodes.

Signs and symptoms Testicular Cancer

Signs and symptoms Firm, painless, smooth testicular mass, varying in size and sometimes producing a sense of testicular heaviness Gynecomastia and nipple tenderness may result if tumor produces chorionic gonadotropin or estrogen may result Dull ache in the lower abdomen or back Lump or swelling in either testicle In advanced stages Ureteral obstruction Abdominal mass Cough, hemoptysis, shortness of breath Weight loss Fatigue, pallor, lethargy

Diagnostic Lab Test results

Diagnostic test results Scrotal ultrasound confirms the presence of a solid mass. Laboratory studies show elevated human corticotropin, human chorionic gonadotropin (HCG), and alfa fetoprotein (AFP) (nonseminoma) or elevated HCG and normal AFP (seminoma). Tissue biopsy confirms the diagnosis and stages the disease.

Treatment for Testicular Cancer

Treatment Surgery Orchiectomy and retroperitoneal node dissection Hormone replacement therapy after bilateral orchiectomy Postoperative radiation Seminoma—retroperitoneal and homolateral iliac nodes Nonseminoma—all positive nodes Retroperitoneal extension—mediastinal and supraclavicular nodes prophylactically Combination chemotherapy Essential for tumors beyond stage 0 Agents include bleomycin, etoposide, and cisplatin; cisplatin, vindesine, and bleomycin; cisplatin, vinblastine, and bleomycin; cisplatin, vincristine, methotrexate, bleomycin, and leucovorin Unresponsive malignancy Chemotherapy and radiation Autologous bone marrow transplantation Clinical Tip: Staging Testicular Cancer The extent of metastasis determines the stage of testicular cancer.


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