To prevent testicular malignancies (testicular tumors), attention must be paid to reducing individual risk factors. Behavioral risk factors Consumption of stimulants Tobacco use-increase ratio (of number of marijuana users to nonusers) 18% (OR 1.18), but here not for nonseminomatous but for germ cell tumors of the testis Drug use Cannabis (hashish and marijuana) → 71% … Testicular Tumors (Testicular Malignancies): Prevention
Tumor type and radiation sensitivity: Seminoma is highly radiosensitive. Non-seminoma is only moderately sensitive to radiation. Radiation therapy measures: “For eradication of GCNIS (Germ cell neoplasia in situ; germ cell tumor in situ) after organ-preserving therapy in single testis, adjuvant irradiation of the affected testis with 18-20 Gy should be performed. Since the appearance of … Testicular Tumors (Testicular Malignancies): Radiotherapy
The following symptoms and complaints may indicate testicular malignancies (testicular tumors): Leading symptoms Painless swelling of the testis Feeling of heaviness in the testicle Pulling pain Associated symptoms Lumbaralgia (back pain) or flank pain (in retroperitoneal metastasis/daughter tumors). Gynecomastia (enlargement of the male mammary gland; 7% of cases, especially in nonseminomas) Signs of B-symptomatology* or … Testicular Tumors (Testicular Malignancies): Symptoms, Complaints, Signs
Pathogenesis (development of disease) Testicular malignancies involve uncontrolled growth, usually originating in the germ cells (85-90% of testicular tumors). Etiology (Causes) Biographic causes Genetic burden – positive family history of first generation relatives. 39 risk genes explain one-third of father and son seminomas Genetic diseases Klinefelter syndrome – genetic disorder with mostly sporadic inheritance: numerical … Testicular Tumors (Testicular Malignancies): Causes
General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (max. 25 g alcohol per day). Preservation of normal weight strive! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised program for underweight. Avoidance of environmental stress: … Testicular Tumors (Testicular Malignancies): Therapy
Infectious and parasitic diseases (A00-B99). Testicular tuberculosis Musculoskeletal system and connective tissue (M00-M99). Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99) Epididymitis (inflammation of the epididymis). Epididymoorchitis – inflammation of the epididymis and testis. Testicular torsion – torsion of the testicle with the spermatic cord and blood vessels, which without therapy can lead to … Testicular Tumors (Testicular Malignancies): Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by testicular malignancies (testicular tumors): Endocrine, nutritional, and metabolic diseases (E00-E90). Hypogonadism (hypofunction of the gonads). Circulatory system (I00-I99) Cardiovascular disease due to acute and long-term toxicities. Neoplasms and tumor diseases (N00-N99). Metastasis (formation of daughter tumors), especially to the following … Testicular Tumors (Testicular Malignancies): Complications
Histopathologic classification of germ cell tumors (KZT) of the testis according to WHO 2004. Seminoma Pure seminoma Spermatocytic seminoma Non-seminomatous germ cell tumors (NSGCT). Embryonal cell carcinoma Yolk sac tumor Chorionic carcinoma Teratoma Mixed tumors from multiple histological types Other histopathological classification Tumors with only one histological type Yolk sac tumor Embryonal carcinoma Polyembryoma Seminoma … Testicular Tumors (Testicular Malignancies): Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection and palpation (palpation) of the mammae (mammary glands) [gynecomastia/enlargement of the male mammary gland]. Inspection and palpation of the abdomen (belly) [abdominal mass?); exclusion of supraclavicular lymph … Testicular Tumors (Testicular Malignancies): Examination
Laboratory parameters of 1st order – obligatory laboratory tests. Small blood count Differential blood count Inflammatory parameter – CRP (C-reactive protein) Tumor markers of testicular carcinoma (also considered prognostic factors): Β-HCG* (β-subunit of human chorionic gonadotropin) [Positive: 30% of cases]. Α-fetoprotein* (AFP). Lactate dehydrogenase* (LDH) Human placental alkaline phosphatase (hPLAP). * Tumor markers that should … Testicular Tumors (Testicular Malignancies): Test and Diagnosis
Therapeutic target Healing Therapy recommendations Germ cell tumors/seminoma Seminoma is very sensitive to radiation. The risk of occult metastasis (daughter tumor formation not yet detectable despite regular staging) to the locoregional lymph nodes (in the immediate vicinity of the tumor) in stage I is approximately 20% (EBM IIB: 100, 127-129). Nevertheless, a cure rate of … Testicular Tumors (Testicular Malignancies): Drug Therapy
Obligatory medical device diagnostics. Scrotal sonography/sonography (ultrasonography) of the scrotal contents (testis and epididymis) (minimum 7.5 MHz transducer) [Sensitivity (percentage of diseased patients in whom the disease is detected by use of the procedure, ie, a positive finding occurs): 100 %] Contrast-enhanced ultrasound (CEUS) significantly improves diagnosis.[Differentiation of avascular, hypo- and hypervascularized processes/increased density of … Testicular Tumors (Testicular Malignancies): Diagnostic Tests
