Incidence: (from SEER Database)
- Non-seminomas: increase by 24% over past 2 decades
- Seminomas: increase by 62% over past 2 decades
- 10% occur in undescended testes, even after orchidopexy
- 5% occur in the contralateral testicle
- 15-40 years old: Commonest tumour in males between
- 20-30 years old: Teratoma
- 30-40 years old: Seminoma
- Baseline: FBC, LFTs, Renal Function
- Tumour Markers: B-HCG, LDG, AFP (not raised in seminoma)
- Dipstick + microscopy, culture and sensitivity
Stage the cancer in accordance with the Royal Marsden Hospital Criteria
- Isolated to the testes
- Abdominal lymph node involvement (para-aortic nodes)
- Supradiaphragmatic lymph node involvement
- Extralymphatic metastasis.
- Surgery: Radical Orchidectomy (gold standard in diagnosis)
- Radiotherapy: Seminomas are sensitive
- Chemotherapy: Efficacious against non-seminomas (Bleomycin, epotposide, cisplatin)
LOVE TO SHOW OFF?
- Produced by embryonal carcinoma and choriocarcinoma.
- Nonseminomatous: the most commonly elevated tumor marker.
- Seminoma: elevated in 15 to 25%
- Absent in the serum of normal adults
- Non-seminomas: Elevated (and hepatocellular carcinoma)
- Pure seminomas: no elevation.
- Less sensitive and less specific tumor marker than beta-hCG or AFP
- Elevated in 40-60% of testicular germ cell tumours.