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testicular cancer (ancillary (staging (CT lungs, liver, and…
testicular cancer
ancillary
alpha-fetoprotein
B-hCG
oestradiol
LH
FSH
testosterone
staging
CT lungs, liver, and retroperitoneal area
pathophysiology
seminomas arise from seminiferous tubles represent a low-grade malignancy (most common)
metastasises to the lungs via lymph
germ cell carcinoma
non-seminoma
embryonal carcinoma
yolk sac carcinoma
choriocarcinoma
teratoma (most common)
arise from primitive germinal cells and tend to occur at a younger age than seminomas.
can be mixed
treatment
medicine
radiotherapy
chemotherapy
bleomycin
etoposide
cisplatin
surgery
radical inguinal orchidectomy
retroperitoneal lymph node dissection
for recurrent or residual nodal masses
fertility and sperm banking
prognosis
B-hCG and AFT good markers of prognosis
seminoma 90-95% survival 5 years
teratoma 60-95% survival 5 years
incidence
uncommon
20-40y
clinical
symptoms
painless lump
testicular ache
metastatic sx
signs
lump not separable from the testis
supraclavicular lymphadenopathy
gynaecomastia - choriocarcinoma
definition
cancer of the testes
seminomatous
non-seminomatous
aetiology
?
genetic
cryptorchidism
FHx
prior testicular cancer
infertility
environmental exposure
diagnosis
USS
complications
treatment
treatment-related toxicity
pulmonary
pneumonitis
pulmonary fibrosis
renal
decr GFR
CV
CAD
HTN
dyslipidaemia
thromboembolic event
raynaud phenomenon
infertility
haem
anaemia
neutropenia
ototoxicity
secondary malignancy
solid tumour
leukaemia