Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- age 20 to 34 years
- testicular mass
Other diagnostic factors
- extratesticular manifestation
Risk factors
- cryptorchidism
- gonadal dysgenesis
- family history of testicular cancer
- personal history of testicular cancer
- testicular atrophy
- white ethnicity
- HIV infection
- occupational exposures
- inguinal hernia
- genetic abnormality
Diagnostic investigations
1st investigations to order
- ultrasound with colour Doppler of testis
- chest imaging
- CT scan abdomen and pelvis with contrast
- serum beta-human chorionic gonadotrophin (beta-hCG)
- serum alpha-fetoprotein (AFP)
- serum lactate dehydrogenase (LDH)
- histological examination of testicular mass post-orchiectomy
Investigations to consider
- serum placental alkaline phosphatase
- MRI abdomen and pelvis
- CT scan chest
- biopsy of contralateral testis
Treatment algorithm
suspicious testicular mass
early-stage seminoma
early stage non-seminoma
seminoma or non-seminoma: stage IIC or stage III disease
seminoma or non-seminoma: relapse disease
Contributors
Authors
Al B. Barqawi, MD, FRCS
Professor of Surgery/Urology
University of Colorado Anschutz Medical Campus
Aurora
CO
Disclosures
ABB declares that he has no competing interests.
Corbin J. Eule, MD
Assistant Professor of Medical Oncology
University of Colorado Anschutz Medical Campus
Aurora
CO
Disclosures
CJE declares that he has no competing interests.
Acknowledgements
Dr Al B. Barqawi and Dr Corbin J. Eule would like to gratefully acknowledge Dr Elizabeth R. Kessler, Dr Thomas W. Flaig, and Dr Brandon Bernard, previous contributors to this topic.
Disclosures
ERK, TWF, and BB declare that they have no competing interests.
Peer reviewers
Elisabeth Heath, MD
Assistant Professor of Medicine and Oncology
Karmanos Cancer Institute
Wayne State University
Detroit
MI
Disclosures
EH declares that she has no competing interests.
Gianfilippo Bertelli, MD, PhD, FRCP (Edin)
Consultant/Honorary Senior Lecturer in Medical Oncology
SW Wales Cancer Institute/Department of Oncology
Singleton Hospital
Sketty
Swansea
UK
Disclosures
GB declares that he has no competing interests.
Emilio Porfiri, MD, PhD
Senior Lecturer in Medical Oncology
School of Cancer Sciences
University of Birmingham
Birmingham
UK
Disclosures
EP declares that he has no competing interests.
Differentials
- Testicular torsion
- Epididymo-orchitis
- Scrotal hernia
More DifferentialsDiretrizes
- NCCN clinical practice guidelines in oncology: testicular cancer
- Diagnosis and treatment of early stage testicular cancer
More GuidelinesFolhetos informativos para os pacientes
Testicular cancer
Testicular cancer: questions to ask your doctor
Mais Folhetos informativos para os pacientes
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