Testicular cancer
Updates to Article Attributes
Testicular cancers are the most common malignancy in men between the ages of 20 and 34 years.
Epidemiology
Testicular cancer is uncommon, accounting for less than 1% of all internal organ malignancies 2.
The commonest histology of the tumour varies with the age of affected individuals. Over 90% of all tumours of the testes are primary germ cell tumours, and as such young adults are the overall most frequently involved group:
- 1st decade: yolk sac tumour and testicular teratoma
- 2nd decade: choriocarcinoma
- 3rd decade: embryonal cell carcinoma
- 4th decade: seminoma
- ≥7th decade: lymphoma (usually non-Hodgkin lymphoma) and spermatocytic seminoma
Risk factors
- cryptorchidism
- Klinefelter syndrome
- family history
- radiation
- previous history of contralateral testicular tumour
- infections: HIV, mumps, etc.
- microlithiasis
- hypospadia
See: risk factors for testicular germ cell tumours
Clinical presentation
In a recent large case-control study, the commonest symptoms associated with a diagnosis of testicular cancer were a swollen testis/scrotum and/or a lump 4.
Pathology
Classification
- primary tumour: 94% of all tumours
-
testicular germ cell tumour: 90% of primary tumours
-
testicular seminoma: 40% of germ cell tumours 1
- classic
- anaplastic
- spermatocytic
-
non-seminomatous germ cell tumour (NSGCT): 60% of germ cell tumours
- testicular mixed germ cell tumour: (~33%, typically one or more NSGCTs and seminoma) 2
- testicular embryonal cell carcinoma (~10%)
- testicular teratoma (~4%)
- testicular yolk sac tumour (~1%)
- testicular choriocarcinoma (~0.3%)
-
testicular seminoma: 40% of germ cell tumours 1
- testicular non-germ cell tumour: 10% of primary tumours
- primary testicular lymphoma
-
testicular germ cell tumour: 90% of primary tumours
- secondary tumour: 6% of all tumours
- secondary testicular lymphoma
- testicular leukaemia
- metastasis to testis
Regional lymph nodes
The following retroperitoneal lymph node stations are considered regional:
- aortocaval
- para-aortic
- paracaval
- preaortic
- precaval
- retroaortic
- retrocaval
The left and right testes have differing lymphatic drainage. The left testis primarily drains through the para-aortic lymph nodes. The right testis primaryprimarily drains through the aortocaval nodes.
Metastatic sites
Metastases from testicular tumours most commonly occur to the lymphatic system followed by lung, liver and bone, and other visceral sites.
Staging
Radiographic features
See the individual articles.
See also
-</ul><p>The left and right testes have differing lymphatic drainage. The left testis primarily drains through the para-aortic lymph nodes. The right testis primary drains through the aortocaval nodes.</p><h5>Metastatic sites</h5><p>Metastases from testicular tumours most commonly occur to the <a href="/articles/lymphatic-system">lymphatic system</a> followed by lung, liver and bone, and other visceral sites.</p><h5>Staging</h5><ul><li><a href="/articles/testicular-cancer-staging-1">testicular cancer staging</a></li></ul><h4>Radiographic features</h4><p>See the individual articles.</p><h4>See also</h4><ul>- +</ul><p>The left and right testes have differing lymphatic drainage. The left testis primarily drains through the para-aortic lymph nodes. The right testis primarily drains through the aortocaval nodes.</p><h5>Metastatic sites</h5><p>Metastases from testicular tumours most commonly occur to the <a href="/articles/lymphatic-system">lymphatic system</a> followed by lung, liver and bone, and other visceral sites.</p><h5>Staging</h5><ul><li><a href="/articles/testicular-cancer-staging-1">testicular cancer staging</a></li></ul><h4>Radiographic features</h4><p>See the individual articles.</p><h4>See also</h4><ul>
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