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]

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]

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]

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

• 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]

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]

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]

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 I 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. [myhealth.alberta.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]

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]

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

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]

Testicular Cancer Oncolex - Oslo University Hospital (Norway) and MD Andersen (USA) Detailed reference article covering etiology, histology, staging, metastatic patterns, symptoms, differential diagnoses, prognosis, treatment and follow-up. [cancerindex.org]

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]

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]

As such, it’s not possible to prevent testicular cancer in most cases. For this reason, early detection is key. [gopedal.org]