Please enable JavaScript.
Coggle requires JavaScript to display documents.
testicular cancer (diagnosis (differential dx (if positive…
testicular cancer
diagnosis
imaging
ultrasound
seminoma
hypoechoic
homogenous
sharp margins
non seminoma
inhomogenous
calcified or cystic
CT
histopatological confirmation
testis removed prior to pathology
differential dx
if
positive transilumination
hydrocele
if
bag of worms
varicocele
if
bowel sounds
scrotal hernia
epidemiology
age
20-35
risk factors
cryptorchidism
Klinefelter Sx
Down Sx
histology
germ cell
seminoma
good radiosensitivity
good prognosis
non seminoma
testicular choriocarcinoma
most aggressive
produces HCG
yolk sac
produces afp
teratoma and embryonal carcinoma
more frecuent 25%
non germ cell
leydig
produces testosterone
sertoli
lymphoma
most common in > 60
metastasis
into retroperitoneum (para-aortic nodes)
exception
hematogenously (choriocarcinoma)
to lungs and brain
Tx
seminoma
stage I
carboplatin or radiation
if no rete testis & tumor < 4cm
active surveillance
stage II
radiation therapy or EP
Stage III
BEP + evaluation of residual disease
nonseminoma
stage I
retroperitoneal lymph node dissection + BEP
stage II
stage III