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produst of primary tumors that arise from components of the testis and its appendages
testicular cancer
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age factors for testicular cancer
birth - 10, 20- 40, over 60 yrs
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race factors of testi cancer
caucasians are 4x more likely to develop testi cancer than african americans
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types of testicular cancer
germ cell tumors and non-germal neoplasm
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derived from the germinal epithelium of mature testis, accts for 90% of testicular cancers
germ cell tumors
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derived from cells that support the generation and maturation of sperm, accts for 5% of testi cancer
non-germinal neoplasm
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types of germ cell tumors
seminoma, embryonal cell cancer, teratoma, mixed cell type, choriocarcinoma
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accts for 35% of tumors, most responsive to treatment, common in 40 yr olds
seminoma
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accts for 20% of tumors, most commonly seen in children, characterized by rapid growth and spread
embryonal cell cancer
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accts for 5% of tumors, common in adults and children, prevalent in young children/ infants
teratoma
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accts for 40% of tumors, most are a combination of teratoma and embryonal cell carcinoma
mixed cell type
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accts for 1-3% of tumors, carries poor prognosis
choriocarcinoma
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non-germ cell tumors
leydig cell, and sertoli cell
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most common nongerm cell tumor, accts for 1-3% of all testicular tumors, occurs in 5-9 y/o and 25-35 y/o
leydig cell tumors
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rare, accts for less than 1% of testi tumors, occur in 1 y/o or younger and 20-45 y/o
sertoli cell tumors
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symptoms of testicular cancer
painless enlargement, sensation of heaviness, pain or asymptomatic, dyspnea or cough(pulmonary metastasis), bone pain ( bone metastasis)
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signs of testicular cancer
firm, not tender testicular mass; hydrocele may accompany mass
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diagnostic exams
- palpation,
- scrotal ultrasound
- abd, chest, and and cervical region exam
- serum tumor markers- AFP, HCG, LDH
- LDH
- chest x-ray
- CT scan of chest, abd and pelvis
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treatment for low stage seminoma
radiosensitive, radical orchiectomy, retropertitoneal irradiation, chemo
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treatment for high stage seminoma
chemo, orchiectomy
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treatment for low stage nonseminomatous germ cell tumor
RPLND, orchiectomy, chemo
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treatment for high level nonseminomatous germ cell tumor
orchiectomy, chemo, RPLND
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