What are the risk factors for testicular tumors ?
Undescended testis
hypospadias
Decreased spermatogenesis or infertility
Family history of testicular tumor,(sibling/father)
Presence of testicular tumor on the contralateral side.
What complaints do patients with Testicular Tumor present with?
Painless mass in bags and eggs: It is considered malignant until proven otherwise.
Pain (may accompany in 20-27% patients)
Gynecomastia 7% ( It is more common in non-seminoma tumors)
List and flank pain 11% (if the tumor has spread to these areas, there may be pain)
Orchitis (an event in 10% of patients) testicular inflammation may accompany )
How is the diagnosis of testicular tumors made?
Diagnosis of testicular cancer is usually made by physical examination. Generally, it presents with a painless, unilateral intrascrotal mass. If there is a suspicion of a mass in the testis, it is considered a malignant disease until proven otherwise. 20-30% of patients also have pain apart from the mass. Pain may be due to bleeding into the tumor or secondary inflammation in 10% of cases. >
AFP, B-HCG, LDH
With which diseases can testicular tumors be confused?
Epididymoorchitis , Hydrocele, Testicular torsion, Spermatocele, Hematocele, Inguinal hernia, Hamatoma, Epidermoid cyst
How is the treatment of testicular tumors?
After physical examination, ultrasound and tumor markers, if tumor suspicion is strong, it is necessary to take the testicle containing the tumor. The testis is removed by a surgical operation called inguinal orchiectomy, which will be performed over the groin. The resulting testicular tissue is sent to pathology. The disease is staged according to the pathology result. For this, lung tomography, whole abdomen CT / MR, tumor Look at the r markers. The disease is staged and additional treatment is planned accordingly.
How is staging done in testicular tumors?
Staging is very important in terms of planning appropriate treatment and obtaining information about prognosis. “The proposed staging system today is the TNM system. Although it is not a detectable disease, high serum tumor markers after orchiectomy should suggest metastasis or residual disease. The fact that tumor markers decreased to normal levels after orchiectomy does not indicate the absence of tumor metastasis.
Clinical Staging
Stage I: Tumor Confined Into Testicle
Stage II A: Presence of <2cm Lymph Node in the abdomen
p>Stage II B: Presence of > 2 cm , < 5 cm lymph nodes in the abdomen or Mediastinal lymph node involvement
Stage IV: Other Organ Involvement
Surgical treatment: Retroperitoneal lymph node dissection (RPLND) in men with advanced or high-risk cancer ) can be applied.
Chemotherapy : Chemotherapy drugs can be administered to treat cancerous cells that have spread outside the testis.
Radiation Therapy: Radiotherapy can be applied to some testicular cancer patients. In addition, radiotherapy can be used with chemotherapy in some patients with metastases or who are not suitable for surgery.
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