some facts
TESTICULAR CANCER:
The patient may complain of a dull ache or a sense of scrotal heaviness.
commonly occurring cancers in young men, with an average patient age of 32 years.
A significantly increased incidence of testicular cancer is found in patients with cryptorchidism, developing in both the nondescended and the contralateral descended testes.
Leydig's cell tumors:
When examining patients with a testicular mass, evaluation for gynecomastia should also be performed. Leydig's cells produce testosterone.
Ninety-seven percent of testicular tumors are germinal in origin, with seminoma being the most common, followed by embryonal cell carcinoma, teratoma and choriocarcinoma.
Nonseminoma tumors are often made up of more than one type of cell, and are identified according to these different cell types:
Choriocarcinoma (rare)
Embryonal carcinoma
Teratoma
Yolk sac tumor
Serum AFP is excreted to varying degrees by NSGCT but not by pure seminoma. An elevated AFP level implies NSGCT or mixed tumor. About one half of NSGCT and mixed tumors will secrete beta HCG, as will about 10 percent of pure seminomas. Seminomas have elevated Placental Alk. phosphotase in 50% of cases.
Management. Radical orchiectomy with high ligation of the spermatic cord via an inguinal approach is appropriate for surgery on testicular masses.
The tremendous improvement in cure rates is due in large part to the introduction of cisplatin (Platinol) chemotherapy.
