testicular cancer

Testicular cancers are the most common neoplasm 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 .

The demographics of affected individuals depends on the age of the histology of the tumor. Over 90% of all tumors of the testes are primary germ cell tumors, and as such young adults are the overall most frequently involved group.

It is interesting to note that among the germ cell tumors there is also stratification according to age, with some tumors being more common in some age groups than others:

• 1decade: yolk sac tumor and testicular teratoma
• 2 decade: choriocarcinoma
• 3 decade: embryonal cell carcinoma
• 4 decade: seminoma
• ≥7decade: lymphoma (usually non-Hodgkin lymphoma) and spermatocytic seminoma

Risk factors

• cryptorchidism
• Klinefelter syndrome
• family history
• radiation
• previous history of contralateral testicular tumor
• infections: HIV, mumps, etc.
• microlithiasis
• hypospadia

See: risk factors for testicular germ cell tumors

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 .

Pathology

Classification

• primary tumor: 94% of all tumors
  • testicular germ cell tumor: 90% of primary tumors
    • testicular seminoma: 40% of germ cell tumors
      • classic
      • anaplastic
      • spermatocytic
    • non-seminomatous germ cell tumor: 60% of germ cell tumors
      • testicular mixed germ cell tumor: (~33%, typically one or more NSGCT and seminoma) 
      • testicular embryonal cell carcinoma (~10%)
      • testicular teratoma (~4%)
      • testicular yolk sac tumor (~1%)
      • testicular choriocarcinoma (~0.3%)
  • testicular non-germ cell tumor: 10% of primary tumors
    • Sertoli cell tumor
    • Leydig cell tumor
    • granulosa cell tumor of the testicle
    • fibroma-thecoma of the testicle
  • primary testicular lymphoma
• secondary tumor: 6% of all tumors
  • secondary testicular lymphoma
  • testicular leukemia
  • metastasis to testis

Regional lymph nodes

The following lymph node regions are considered regional:

• aortocaval
• para-aortic (periaortic)
• paracaval
• preaortic
• precaval
• retroaortic
• retrocaval

The left and right testicles have differing lymphatic drainage. The left testicle primarily drains through the para-aortic lymph nodes. The right testicle primary drains via the aortocaval nodes.

Metastatic sites

Metastases from testicular tumors most commonly occur to the lymphatic system followed by lung, liver and bone, and other visceral sites.

Staging

• testicular cancer staging

Radiographic features

See the individual articles.

See also

• unilateral testicular lesions
• bilateral testicular lesions
• paratesticular lesions

Siehe auch:

• Keimzelltumor
• Chorionkarzinom
• Hodentumoren
• Seminom
• Makroorchidie
• Lipom des Hodens
• unilateral testicular lesions
• Metastasen im Hoden
• paratestikuläre Läsionen
• Tuberkulose des Hodens und Nebenhodens
• testicular sarcoidosis
• Teratom des Hodens
• Leydig-Zell-Tumor des Hodens
• bilateral testicular masses
• testicular yolk sac tumour
• testicular cancer staging
• nichtseminomatöser Keimzelltumor
• Dottersacktumor
• testicular germ cell tumour
• testicular mixed germ cell tumour
• Lymphom des Hodens

und weiter:

• genitourinary curriculum
• cancer
• Hodenabszess
• Mamma accessoria
• Gynäkomastie
• Seminom des Hodens
• bilateral testicular lesions
• testicular adrenal rests
• AIDS defining malignancies
• testicular mixed germ cell tumours
• cryptorchidism with neoplastic transformation (seminoma)
• malignant mesothelioma of the tunica vaginalis testis
• testicular plasmacytoma
• juveniler Granuloszelltumor des Hodens