Seminoma
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- 95% of testicular tumors are what type of tumor? What are the 2 subtypes and generally how does their treatment differ?
- germ cell tumors are 95% of testicular tumors. of these, 40% are pure seminomas and ajunctive RT is standard of care. 60% are non-seminomas and RT is palliative
- Testicular cancer accounts for only 2% of cancer. What has happened to the incidence in the past 40 yrs?
- The incidence of testicular cancer has doubled in the past 40 yrs.
- What are the main risk factors for testicular tumors?
- men aged 15-34, h/o cryptochidism, assoc w/ dysplastic nevus synd and Klinefelter's synd, HIV infxn, race: 5x increase in white vs blk, chromosomal abnorm in chromo 1+12
- pure seminomas account for __% of germ cell tumors. What are the 3 subtypes? Which is most common?
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1. Classic Seminoma 85%
2. Anaplastic Seminoma
3. Spermatocytic Seminoma - non-seminomas acct for __% of germ cell tumors. What are the main types?
- Non-seminomas are 60% of germ cell tumors. 1. embryonal 2. teratoma 3. choriocarcinoma 4. mixed
- germ cell tumors are __% of testicular tumors while non-germ cell tumors are __%. What are subtypes of the non-germ cell tumors?
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Testicular tumors: germ cell (95%), non-germ cell (5%)
(stromal and lymphoma) - Germ cell tumors frequently produce proteins that can serve as tumor markers for disease burden/diagnosis. What are 3 most important ones?
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alpha-feto protein (AFP)
beta-HCG
LDG - characteristic serum marker elevation in seminomas
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AFP should be zero
may produce some HCG - half life of AFP
- 4-6 days
- half life of b-HCG
- 1-2 days
- what might account for the gynecomastia in 5% of the testicular cancer patients?
- the elevated HCG
- why are scrotal incisions contraindicated if suspicion is high for a testicular tumor?
- concern for altering the lymphatic pattern of drainage
- what are the clincal prognostic factors in seminomas?
- only stage and disease burden are of clinic significance. the histologic subtype and serum HCG are not of prognostic value