(Cancer) (Surgery)

Overview

• Very common malignancy in young adult men, 20-34 yrs old
• Types → Seminomas (50%), Non-semianoma tumours (teratomas), Non-germ cell tumours (5%)
  • Teratomas have worse prognosis than seminomas
• Risk Factors → Cryptorchidism (undescended testes), infertility, age <45, positive family history, previous diagnosis of testicular cancer, testicular atrophy
• Typically spread to para-aortic lymph nodes

Making Diagnosis

Clinical Features:

• Painless hard nodular testicular mass → unilateral
• Negative transillumination test → light does not shine through
• Gynaecomastia → due to seminoma secreting hCG (increased oestrogen:androgen ratio)
• May be associated hydrocele
• Lymphadenopathy
• Metastatic Disease → cough, SOB, chest pain, bone pain (backache)

Investigations: