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Testicular cancer

Last reviewed: 25 Jun 2024
Last updated: 16 Jan 2024

Summary

Definition

History and exam

Key diagnostic factors

  • age 20 to 34 years
  • testicular mass
Full details

Other diagnostic factors

  • extratesticular manifestation
Full details

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
Full details

Diagnostic tests

1st tests to order

  • ultrasound with color Doppler of testis
  • chest imaging
  • CT scan abdomen and pelvis with contrast
  • serum beta-human chorionic gonadotropin (beta-hCG)
  • serum alpha-fetoprotein (AFP)
  • serum lactate dehydrogenase (LDH)
  • histologic exam of testicular mass postorchiectomy
Full details

Tests to consider

  • serum placental alkaline phosphatase
  • MRI abdomen and pelvis
  • CT scan chest
Full details

Treatment algorithm

INITIAL

suspicious testicular mass

ACUTE

early-stage seminoma

early-stage nonseminoma

ONGOING

seminoma or nonseminoma: stage IIC or stage III disease

seminoma or nonseminoma: 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.

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