Testicular cancer

Last reviewed: 29 Oct 2022
Last updated: 07 Sep 2022

Summary

Definition

History and exam

Key diagnostic factors

  • age 20 to 34 years
  • testicular mass
More key diagnostic factors

Other diagnostic factors

  • extratesticular manifestation
Other diagnostic factors

Risk factors

  • cryptorchidism
  • gonadal dysgenesis
  • family history of testicular cancer
  • personal history of testicular cancer
  • testicular atrophy
  • white ethnicity
  • HIV infection
  • chemical carcinogens and low sperm count
  • rural residence
  • higher socioeconomic status
  • inguinal hernia
  • genetic abnormality
More risk factors

Diagnostic investigations

1st investigations to order

  • ultrasound with color Doppler of testis
  • CXR
  • CT scan (abdomen and pelvis)
  • serum beta-human chorionic gonadotropin (beta-hCG)
  • serum alpha-fetoprotein (AFP)
  • serum lactate dehydrogenase (LDH)
  • histologic exam of testicular mass postorchiectomy
More 1st investigations to order

Investigations to consider

  • serum placenta alkaline phosphatase
  • serum gamma glutamyl transpeptidase (gamma-GT)
  • MRI scan (abdomen and pelvis)
  • CT scan chest
More investigations to consider

Treatment algorithm

INITIAL

suspicious testicular mass

ACUTE

early-stage seminoma

early-stage nonseminoma

ONGOING

seminoma or nonseminoma: advanced cancer/metastasis (stage IIC or stage III disease)

seminoma or nonseminoma: relapsing disease

Contributors

Authors

Al B. Barqawi, MD, FRCS

Associate Professor of Surgery/Urology

Director of Prostate Cancer Fellowship Program

School of Medicine

University of Colorado Denver

Aurora

CO

Disclosures

ABB declares that he has no competing interests.

Brandon Bernard, MD, FRCPC

Assistant Professor

University of Colorado Denver School of Medicine

University of Colorado Cancer Center

Aurora

CO

Disclosures

BB declares that he has no competing interests.

Acknowledgements

Dr Al B. Barqawi and Dr Brandon Bernard would like to gratefully acknowledge Dr Elizabeth R. Kessler and Dr Thomas W. Flaig, previous contributors to this topic.

Disclosures

ERK and TWF 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.

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