A 46-year-old male with a past history of hypertension initially presented to a urologist with a left-sided testicular mass. [healio.com]

History Most patients present with a history of a lump, swelling or hardness detected in the testicle. 10% of patients present with scrotal pain, and a further 10% present with symptoms related to metastatic spread (see symptoms). [health24.com]

Back pain, abdominal discomfort or abdominal mass may be a presenting feature in the 25% of patients who have retroperitoneal nodal metastases 3. Presentation with distant or extranodal metastases is rare (~5%). [radiopaedia.org]

Let’s take a quick look at the clinical presentation, pathologic subtypes, and prognosis of this common cancer. Clinical Presentation Testicular cancer usually presents as a firm, painless enlargement of the testis. [pathologystudent.com]

Critical Essential Core Tested Community Questions (4) (M2.ON.75) A 30-year-old male presents with a testicular mass of unknown duration. [medbullets.com]

• Infertility

  In the past, doing this often caused infertility. Modern nerve-sparing methods have greatly lowered the chances of infertility. Having this surgery isn't routine treatment for stage I nonseminoma. [agavesurgery.com]

  In the past, doing this often caused infertility. Modern nerve-sparing methods have greatly lowered the chances of infertility. Having this surgery isn't routine treatment for stage I non-seminoma. [healthlinkbc.ca]

• Fatigue

  Many treatments cause you to feel very tired (fatigue). Surgery: You may experience some pain after surgery and some swelling or bruising of your scrotum. Your doctor will prescribe painkillers to relieve this. [cancer.ie]

  Most (such as fatigue, nausea, vomiting, and diarrhea) are short-term. That means they go away when treatment is done. Other side effects can affect your future lifestyle and health. [uwhealth.org]

  Side effects of radiotherapy can include: reddening and soreness of the skin, which is similar to sunburn nausea diarrhoea fatigue These side effects are usually only temporary and should improve when your treatment is completed. [nhs.uk]

• Cough

  Coughing and breathlessness from lung involvement may require specific treatment. References Andrology Australia. Treatment of Testicular Cancer [online]. 2003 [cited April 17, 2003]. [myvmc.com]

  In metastatic disease (10% of cases) Cough, shortness of breath, chest pain Lower back or bone pain Gynecomastia Paraneoplastic hyperthyroidism Until proven otherwise, a firm nodule on the testis should be considered cancer! [amboss.com]

  Advanced testicular cancer can present with weight loss, back pain, chest pain, coughing, difficulty breathing, or enlargement of the lymph nodes in the abdomen or neck. Thankfully, treatment for testicular cancer is often very successful. [gopedal.org]

  • Backaches, coughing or breathlessness or tender nipples. [urologyspecialist.com.au]

  […] testicle Breast growth or soreness Early puberty in boys By other way, there are other symptoms for Testicular Cancer that are more likely to be caused by something other than testicular cancer, such as: Low back pain Shortness of breath, chest pain, or a cough [bioprognos.com]

• Abdominal Mass

  Back pain, abdominal discomfort or abdominal mass may be a presenting feature in the 25% of patients who have retroperitoneal nodal metastases 3. Presentation with distant or extranodal metastases is rare (~5%). [radiopaedia.org]

  mass, back pain, weight loss Headache, nausea, vomiting, ataxia, change in vision Diagnosis Testicular ultrasound : to rule out gonadal primary tumor Tumor markers : alpha fetoprotein ( AFP ) and human chorionic gonadotropin ( HCG ) Tumor biopsy (confirmatory [amboss.com]

  She returned 7 months after the surgery with a large abdominal mass, ascites, right- sided hydronephrosis and massive pulmonary embolism. Due to the widespread disease and her poor general condition, she received only palliative care. [cancerindex.org]

• Hypotension

  In clinical practice, however, it is not commonly used due to its potential for negative side effects, including nausea, vomiting and hypotension, reports of Stevens-Johnson syndrome and toxic epidermal necrolysis, and the costs associated with its administration [healio.com]

• Irritability

  Fecal transplant is used to treat gut infections and is now being studied as a treatment for obesity, urinary tract infections, irritable bowel syndrome and more. [nytimes.com]

  So at the point, at that point I was actually considering that my preference probably would be for surveillance, I was rather irritated to discover that that wouldn't be an option for me so, and I would actually have to go for the radiotherapy. [healthtalk.org]

• Testicular Mass

  Critical Essential Core Tested Community Questions (4) (M2.ON.75) A 30-year-old male presents with a testicular mass of unknown duration. [medbullets.com]

  Tabs Content Clinical Overview Diagnosis Indications for Testing Testicular mass Testicular pain Nonresolving epididymitis/orchitis Laboratory Testing AFP, beta-hCG, and LDH serum concentrations – mandatory prior to testicular cancer treatment Molecular [arupconsult.com]

  A 46-year-old male with a past history of hypertension initially presented to a urologist with a left-sided testicular mass. [healio.com]

  A painless testicular mass is the classic presentation for testicular cancer, although a number of patients present with diffuse pain or swelling. Ultrasonography may be helpful in confirming the presence of a scrotal mass within the testicle. [aafp.org]

• Testicular Pain

  Tabs Content Clinical Overview Diagnosis Indications for Testing Testicular mass Testicular pain Nonresolving epididymitis/orchitis Laboratory Testing AFP, beta-hCG, and LDH serum concentrations – mandatory prior to testicular cancer treatment Molecular [arupconsult.com]

  Testicular pain is reported in up to one fifth of cases. [en.wikipedia.org]

  Indications for Embryonal Carcinoma of the Testis include: Blood in vomit and cough Blood in stool, urine Trouble breathing Headache Low blood pressure Anemia Testicular pain, lump in the testes, feeling of heaviness in the scrotum Abdominal pain and [dovemed.com]

  Testicular pain and/or abdominal pain. Dragging sensation. Recent history of trauma; it is probably the trauma that leads the man to examine himself and find the tumour rather than being the cause of malignant change. Hydrocele. [patient.info]

  Slow declines in AFP and HCG levels are associated with poorer prognosis and disease progression. 10 Most testicular tumors are detectable upon physical examination. They present as a hard mass with diffuse testicular pain and swelling. [uspharmacist.com]

• Swelling of the Scrotum

  Consult a doctor if you have any of these symptoms: Swelling in the scrotum A lump or swelling in either testicle Build-up of fluid on the scrotum Dull ache in the groin or lower abdomen Pain or discomfort in the scrotum or a testicle Cleveland Clinic [my.clevelandclinic.org]

  Patients presenting with a swelling in the scrotum should be examined carefully and an attempt made to distinguish between lumps arising from the testis and other intrascrotal swellings. [patient.info]

  Heat relaxes the scrotum, making it easier to spot anything abnormal. The National Cancer Institute recommends following these steps every month: Stand in front of a mirror. Check for any swelling on the scrotum skin. [washington.edu]

  Most testicular tumours present with a painless lump or swelling of the testis, noted by the patient or his sexual partner. 30-40% of patients complain of a dull ache or heaviness in the scrotum or lower abdomen. [health24.com]

• Scrotal Mass

  In addition, he had a large left-sided scrotal mass that he reported had continued to enlarge during the previous several months. [healio.com]

  Almost all solid masses of the testes itself are cancerous. Almost all scrotal masses not arising from the testes are benign. [health24.com]

  A painless testicular mass is the classic presentation for testicular cancer, although a number of patients present with diffuse pain or swelling. Ultrasonography may be helpful in confirming the presence of a scrotal mass within the testicle. [aafp.org]

  Friend J, Barker A, Khosa J, Samnakay N Benign scrotal masses in children - some new lessons learned. [cancerindex.org]

• Painless Testicular Mass

  The most common presentation is with a painless testicular mass although some 45% will report a degree of testicular discomfort. Bilateral tumors are rare (~2%) and are almost always asynchronous 1. [radiopaedia.org]

  Presentation The classic presentation of a testicular tumor is as a painless testicular mass in an otherwise healthy man in the third or fourth decade of life. [emedicine.medscape.com]

  A painless testicular mass is the classic presentation for testicular cancer, although a number of patients present with diffuse pain or swelling. Ultrasonography may be helpful in confirming the presence of a scrotal mass within the testicle. [aafp.org]

The urologist ordered an ultrasound of the mass; however, the patient chose not to pursue further workup at that time and had no follow-up for approximately 4 months. He then presented to an ophthalmologist for complaints of decreased visual acuity. [healio.com]

Testicular Cancer Workup. Available online at http://emedicine.medscape.com/article/279007-overview. Accessed July 2014. Motzer RJ, Agarwal N, Beard C, et al. Testicular Cancer. [labtestsonline.it]

If signs and symptoms of advanced disease are present, MRI of the brain and bone should be added to the standard diagnostic workup to rule out metastasis. [uspharmacist.com]

Any palpable firmness within the testicular parenchyma should raise suspiscion for malignancy and prompt further workup. Differentiation of the scrotal contents should be found with careful palpation. [emedicine.medscape.com]

The potential benefits of receiving cancer treatment must be carefully balanced with the potential risks of receiving cancer treatment. The following is a general overview of the treatment of stage III testicular non-seminoma. [texasoncology.com]

For more information about testicular cancer, including diagnosis, treatments, and follow-up after treatment, visit BC Cancer Agency Types of Cancer - Testes. [healthlinkbc.ca]

Some men who choose surveillance will need more treatment. [agavesurgery.com]

Men's outlook is defined as having good prognosis, intermediate prognosis or poor prognosis. [cancerresearchuk.org]

If you have testicular cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. [cancer.ca]

AFP < 1000 ng/mL hCG < 5000 IU/L (1000 ng/mL) LDH < 1.5x ULN Seminoma (90% of cases) All of the following criteria: 5-year PFS 82% 5-year survival 86% Any primary site No non-pulmonary visceral metastases Normal AFP Any hCG Any LDH Intermediate prognosis [esmo.org]

Treatment and prognosis The prognosis of non-seminomatous germ cell tumors is variable and depends on the biological behavior of individual tumors. [radiopaedia.org]

Prognosis Overall, the prognosis in testicular cancer is good. With early detection, the cure rate approaches 100%. [pathologystudent.com]

Fine needle aspiration of this retroperitoneal mass was positive for malignant cells and consistent with germ cell tumor etiology. The report stated that the findings were consistent with a seminoma. [healio.com]

The present study aims to determine if socioeconomic factors may play a role in both etiology and survival from non-seminoma testicular cancer. [ncbi.nlm.nih.gov]

Etiology Risk factors Cryptorchidism (increased risk for germ cell tumors ) [4] Contralateral testicular cancer Germ cell neoplasia in situ (GCNIS) Family history of testicular cancer Klinefelter syndrome, Down syndrome (increased risk for germ cell tumors [amboss.com]

(Etiology) The cause of Embryonal Carcinoma of the Testis is unknown. [dovemed.com]

In contrast, the increase in rates has begun to slow in countries such as Australia and the United States [4] Etiology Factors that alter the differentiation of the primordial germ cell, resulting in the presence of an embryonal stem cell, can increase [emedicine.medscape.com]

Kataja This Clinical Practice Guideline for Testicular Seminoma and Non-seminoma features epidemiology of these rare malignancies in young men, the diagnosis, management of the primary tumour, post-orchiectomy staging and risk assessment, treatment recommendations [esmo.org]

[…] more common in Hispanics compared to Asian and black populations in the US References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

[…] primordial germ cells and early gonocytes nonseminomas cells can be undifferentiated and appear as embryonic stem cells (in embryonal carcinoma) cells can differentiate into yolk sac tumors choriocarcinomas teratomas sex cord-stromal tumors (usually benign) Epidemiology [medbullets.com]

Monitoring AFP, LDH, beta-hCG – markers of choice; refer to National Comprehensive Cancer Network (NCCN) Testicular Cancer guidelines (2016) for suggested monitoring schedule Schedule varies based on tumor stage/type and treatment Background Epidemiology [arupconsult.com]

These groups are defined by epidemiological characteristics, histological composition and chromosomal constitution (Table 1). [atlasgeneticsoncology.org]

[…] in African Americans Highest incidence in Caucasians Risk Factors Personal history of testicular cancer Family history of testicular cancer – highest risk if sibling had testicular cancer Cryptorchidism Infertility /subfertility Klinefelter syndrome Pathophysiology [arupconsult.com]

Epidemiology : usually develop after the age of 4 Pathophysiology : produces ↑↑ amounts of testosterone and a small amount of estrogen, progesterone, and corticosteroids → testosterone excess causes precocious puberty in males (and masculinization in [amboss.com]

Furthermore, men with known ITGCN have an approximately 50% risk of cancer developement in 5 years. [5] Pathophysiology As mentioned above, as many as 90% of germ cell tumors are associated with ITGCN. [emedicine.medscape.com]

Cancer Connect 3 days Overview of Melanoma Melanoma: Signs & Symptoms, Diagnosis, Screening, Prevention & Early Detection Cancer Connect 3 days Sunscreen May Reduce Risk of Melanoma Regular use of sunscreen may help prevent melanoma. [news.cancerconnect.com]

Supportive Care: Supportive care refers to treatments designed to prevent and control the side effects of cancer and its treatment. [texasoncology.com]

Prevention Preventing most cases testicular cancer is not possible, as the causes are largely unknown. Many men who develop testicular cancer do not have any known risk factors. [medicalnewstoday.com]

One of the main strategies to prevent nephrotoxicity relies on adequate sodium chloride hydration. This is essential for all patients treated with cisplatin. [healio.com]

Prevention It’s not possible to prevent testicular cancer since most of the risk factors (young age, undescended testicles, being white, etc.) cannot be changed or controlled. [urmc.rochester.edu]