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Testicular Teratocarcinoma

Testicular Embryonal Carcinoma and Teratoma


Presentation

  • A case report of father-son testicular cancers, both teratocarcinomas, is presented and genetic considerations discussed.[ncbi.nlm.nih.gov]
  • In addition, patients with symptomatic disease and patients presenting with visceral metastases carried a poor prognosis [ 2 ].[wjso.biomedcentral.com]
  • The incidence of this disease is increasing—the lifetime risk for a man is now about one in 200 in the United Kingdom. 1 Presentation is usually with a painless lump.[bmj.com]
Upper Abdominal Pain
  • Case report A 22-year-old male patient complaining of right-sided upper abdominal pain.[link.springer.com]
Testicular Mass
  • Case : The patient was a 29-year-old male with a right testicular mass, measuring 8.5 7.5 8.0 cm in diameter.[jstage.jst.go.jp]
  • At a Glance When a patient discovers a usually painless testicular mass, either unintentionally or by self-examination, or when a testicular mass is discovered by routine physical examination, testicular cancer should be suspected.[clinicaladvisor.com]
  • Investigations • All patients with a solid, firm intra-testicular mass that cannot be transilluminated should be regarded as malignant unless otherwise proved. • Scrotal Ultrasound - • rapid, reliable technique • hypoechoic area within the tunica albuginea[slideshare.net]
  • The most common presentation of pure teratomas is with a painless testicular mass.[radiopaedia.org]
  • One fifth to two thirds of patients with tumours composed predominantly of embryonal carcinoma have metastases at diagnosis. [1] Signs and symptoms [ edit ] The presenting features may be a palpable testicular mass or asymmetric testicular enlargement[en.wikipedia.org]

Workup

  • Metastatic Workup After the diagnosis is confirmed by radical inguinal orchiectomy, further studies should include repeated markers for hCG (wait 1 week) and AFP (wait 4 weeks) and CT of the chest and abdomen.[flylib.com]
Left Pleural Effusion
  • Chest x-ray documented left pleural effusion. Cultures from thoracentesis grew out Acremonium strictum and intravenous liposomal amphotericin B was given at a dose of 200 mg daily. On treatment, fever subsided but dyspnea worsened.[bjid.org.br]

Treatment

  • Lehman et al. reported a case of retroperitoneal mature teratoma 15 years after initial treatment of testicular germ cell tumor [ 13 ]. Late relapse was observed up to 32 years after initial treatment [ 7 ].[link.springer.com]
  • Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. ‎[books.google.es]
  • On treatment, fever subsided but dyspnea worsened. Whole-body CT scan showed multiple bilateral lung nodules, systemic lymphadenopathies and a mass over the left testis.[bjid.org.br]
  • Only risk factors, treatment possibilities, and survival results are extensively examined. Stimulated by the occurrence in his practice of some puzzling and unexpected metastases, the author reviewed more than 12,000 references.[books.google.com]

Prognosis

  • […] represent the principal predisposing factors. 2 As for the respiratory system, Acremonium strictum has been associated with two types of lesions: multiple bilateral nodules with no halo sign (4 cases) and pleuritis (2 cases including ours). 1–5 The prognosis[bjid.org.br]
  • In addition, patients with symptomatic disease and patients presenting with visceral metastases carried a poor prognosis [ 2 ].[wjso.biomedcentral.com]
  • Germ cell tumors (germinoma, 90643; germ cell tumor, nonseminomatous, 90653) Seminoma (90613, 90623, 90663; most common 40-50%; slow to spread; more likely to occur in older patients; highly radiosensitive; good prognosis) Non-Seminoma (teratoma and embryonal[training.seer.cancer.gov]
  • Prognosis of Testicular Cancer (Teratoma of the Testicle) As with many malignancies, early diagnosis and intervention are critical to subsequent prognosis in patients with testicular cancer.[myvmc.com]

Etiology

  • Etiology • Cryptorchidism • Intersex disorder • Testicular atrophy • Chromosomal abnormalities - loss of chromosome 11, 13, 18, abnormal chromosome 12p. • Exogenous estrogen administration to mother during pregnancy • Carcinoma-in-situ • Previous testicular[slideshare.net]
  • (Etiology) The cause of Teratoma of the Testis is unknown.[dovemed.com]
  • Testicular Tumours epidemiologic, etiologic and pathologic features. Cancer 1973; 32:1186. 8. Kalra VB, Ramdeo IN, Kalra R. Testicular tumors clinicopathological study. Indian J Surg 1977; 39:226. 9. Joshi N, Vickers P, Sharma ML, Joshi RI.[jpgmonline.com]
  • No clear etiologic or genetic factors have been defined; however, 10% of patients have a history of an undescended testis, 50% of which were intraabdominal. Testis cancers will be bilateral in 2% to 3% of cases, either concurrent or in succession.[flylib.com]
  • While the clinical evidence for the involvement of genetic factors in the etiology of GCT is undisputed, the assumed Testicular GCT 1 gene has so far not been identified [ 41 ].[bmcurol.biomedcentral.com]

Epidemiology

  • The epidemiology of testicular cancer. Brit J Urol 1987; 60:285. 12. Young PG, Mount BM, Fools FW, Whitmore WF. Embryonal adenocarcinoma in the prepubertal testis. Cancer 1970; 26:1065. 13. Kimbrough JC, Cook FF. Carcinoma of the testis.[jpgmonline.com]
  • Methods We searched our personal archives of references relating to the epidemiology, diagnosis, and management of testicular germ cell cancers as well as the Cochrane Database for reviews or meta-analyses.[bmj.com]
  • Rates are lowest in Asia and Africa and intermediate in Central and South America. [6] Epidemiologic observations have suggested that environmental factors are instrumental in determining risk for testicular cancers.[emedicine.medscape.com]
  • International Epidemiological Association 2001[ije.oxfordjournals.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology The cause of testicular cancer is not known. The characteristic genetic change found is an isochromosome of the short arm of chromosome 12 [i(12p)], which is often seen in sporadic cancers.[emedicine.medscape.com]

Prevention

  • Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment Adherence United States Preventive[jamanetwork.com]
  • […] tumors Removal of the testis Debulking surgery to reduce tumor size, followed by chemotherapy Clotting the vessels in the tumor (embolization) Chemotherapy Radiotherapy Undertaking treatment of underlying conditions How can Teratoma of the Testis be Prevented[dovemed.com]
  • So, this case represents an exceptional example showing the low efficacy of chemotherapy to prevent sequential testicular neoplasms. (3) Two brothers of case #2 had suffered from testicular cancer, too, one of whom had even bilateral disease.[bmcurol.biomedcentral.com]
  • Frozen section assessment in testicular and paratesticular lesions suspicious for malignancy: its role in preventing unnecessary orchiectomy. Hum Pathol . 2012 Mar 8. [Medline] . American Joint Committee on Cancer. Testis.[emedicine.medscape.com]
  • Cancer Epidemiology and Prevention. 2nd Edn. Oxford: Oxford University Press, 1996, pp.1207–19. 4 Kogan S, Hadziselimovic F, Howards SS, Snyder III HM, Huff D. Pediatric Andrology. In: Gillenwater JY, Howards SS, Grayhack JT, Duckett JW (eds).[ije.oxfordjournals.org]

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