Testicular cancer

Testicular cancer - Chronic

Definition  

A potentially curable cancer affecting primarily young and middle-aged men

 

Medical History  

* Past medical history of Traumatic injury

* Past medical history of Cryptorchidism

* Family history of Cryptorchidism

* Past medical history of Testicular cancer

* Family history of Testicular cancer

* Past medical history of Inguinal hernia

* Klinefelter's syndrome, XXY

* Testicular dysgenesis syndrome

* Hermaphroditism

* Genetic predisposition

* Atrophy of testis

* Testicular torsion

* Environmental Exposure

* Past medical history of Specific viral infections

 

Findings  

* Large testicle

* Low back pain

* Lymphadenopathy

* Testicular mass

* Abdominal mass

* Bone pain

* Chest pain

* Cough

* Dyspnea - Chronic

* Facial swelling

* Headache

* Hemoptysis

* Jaundice

* Nausea and vomiting

* Superior vena cava syndrome

* Weight loss

* Hydrocele

* Pain in testicle

* Gynecomastia

 

Tests  

Suspected or known testicular mass  

* Scrotal ultrasound: Detection of an intratesticular mass with ultrasound is generally highly diagnostic for a testicular tumor .

 

Suspected testicular cancer  

* Alpha-1-fetoprotein measurement, serum: Serum alpha-fetoprotein levels are a principal serum tumor marker in diagnosis and management of testicular tumors, especially germ cell cancers .

 

Suspected testicular cancer  

* Serum quantitative HCG measurement: Serum human chorionic gonadotropin (hCG) elevations are found in 15% to 20% of seminomatous and 40% to 50% of nonseminomatous germ cell testicular tumors .

 

Suspected and known testicular cancer  

* Lactate dehydrogenase measurement: A serum LDH level is essential to diagnosing the presence of germ cell tumors, for determining prognosis, and for evaluating treatment outcomes .

 

Initial evaluation of suspected testicular cancer  

* Plain chest X-ray

 

Differential Diagnosis  

* Epididymitis - Acute

* Testicular torsion - Acute

* Hydrocele

* Scrotal hernia

* Inguinal hernia - Acute

* Varicocele

* Cyst of epididymis

* Hematoma of scrotum

 

Treatment  

 

Drug Therapy  

 

Testicular cancer  

 

CISPLATIN

 

ETOPOSIDE

 

BLEOMYCIN SULFATE  

 

Procedural Therapy  

Suspected and known testicular cancer  

* Orchiectomy: Orchiectomy is necessary for the diagnosis, classification, staging, and treatment of testicular cancer .

 

Suspected and known testicular cancer  

* Excision of retroperitoneal lymph node: Retroperitoneal lymph node dissection is used frequently for diagnostic and therapeutic purposes in patients with nonseminoma .