Testicle tumors
Testicle tumors
Updated: 09/14/2021
© Jun Wang, MD, PhD
General features
- <1% of malignancies in male
- Most commonly seen solid tumor in male age 15-35
- Predominantly germ cell tumors in young patients
- Most common malignant testicular neoplasm if > 60 years: Diffuse large B cell lymphoma
- Lymphatic spread to periaortic, iliac, mediastinal and supraclavicular nodes
- Inguinal nodes usually spared unless scrotal or inguinal surgery or invasion of scrotal wall
- Hematogenous spread to liver, lungs, brain, bones
Germ
Cell Tumors
- Most common tumor 25-29 years
- Either derived from intratubular germ cell neoplasia or not
- Highly curable even with advanced development
- Commonly mixed histologic types
- Higher risk for bilateral tumor if both testes undescended
- p53 mutations are common
- Risk factors: Cryptorchidism, family history, testicular dysgenesis, Li-Fraumeni syndrome, prior testicular germ cell tumor or intratubular germ cellneoplasia
- Prognosis: Depending on histologic type and tumor stage
- Intratubular germ cell neoplasia
Intratubular germ cell neoplasm,
unclassified
Intratubular germ cell neoplasm, specific
type
- Tumors of single histologic type
- Mixed germ cell tumor
- Leydig cell tumor
- Sertoli cell tumor
- Granulosa cell tumor
- Mixed and indeterminate (unclassified) sex cord stromal tumor
Other
Tumors
Clinical features
- Usually painless mass
Diagnostic approach
- History
- Morphology
- Serum markers, same as ovarian germ cell tumors
hCG: trophoblast components
PLAP: seminoma
AFP: yolk sac tumor
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