- Testicular Tumors
Although it is generally considered a rare cancer, it is the most common organ cancer in men between the ages of 15-35. According to the American Cancer Society data, the number of cases in 2016 in the USA, which has a population of 320 million, was approximately 9000. We do not have any definitive data about the cause. The majority of patients with testicular cancer have a chromosome abnormality (isochromosome-i12p on the short arm of chromosome 12), and it is assumed that exposure to a developmental defect during the embryological development of the testicle causes subsequent tumor development. The risk of occurrence within the same family is increased. In other words, if the father has testicular cancer, the risk of developing it in his sons or those with a brother who has testicular cancer is 8-10 times higher than the normal population. There is a similar increase in risk in those with a history of undescended testicles.
- Symptoms - Findings and Diagnosis
In young men, there is a similar increase in risk. Hardness, irregularity or wholesale enlargement of a testicle is the most common initial form. There is usually no pain or there is a mild, dull pain.
The first tool used in diagnosis is ultrasonography (US). In addition, some substances that may be released from the tumor tissue in the testicle are measured by blood tests, and if these test results are found to be high, they are also used as post-treatment follow-up criteria for malignant testicular tumors(AFP and bHCG-testicular tumor markers).
After the testicular mass lesion is identified with US, upper-lower abdominal computed tomography is performed due to the risk of spread to the lymphatic system in the abdomen. In addition, a lung x-ray is taken to consider the risk of spread, and the stage of the cancer is determined through these.
In rare cases where there is suspicion that the mass in the testicle is a tumor or there is suspicion of spread to the testicle while there is cancer elsewhere in the body, a biopsy can be performed. Apart from these, Biopsy is not recommended.
- Treatment
The first thing to do is to remove the cord of the diseased testicle, both to confirm the diagnosis and as the first step of the treatment. is its complete removal (radical orchiectomy). In most patients This intervention is sufficient treatment.
However, for our patients at risk of spread, additional treatments may be recommended in the light of the cancer cell type obtained from the pathology report, the level of tumor markers measured in the blood, and the findings of abdominal tomography and chest radiography. Accordingly, only follow-up, radiotherapy targeting the intra-abdominal lymph nodes, or one or several courses of chemotherapy may be given without the need for any additional treatment. Removal of intra-abdominal lymph nodes may also be considered at the beginning of treatment or at any stage during follow-up.
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