TUMORI DEL TESTICOLO.pptVIP

Staging of GCTs Stage I – Testis only, T1 Stage II – T2-4, vascular or lymphatic invasion present Stage IIA – nodes 2 cm Stage IIB – nodes 2-5 cm Stage IIC – nodes 5 cm Stage III – Distant metastases Primary Germ Cell Tumors of the testis Usually present with painless testicular mass Retroperitoneal mets can cause back pain Pulmonary mets can cause dyspnea Initial test if suspicious for malignancy - testicular ultrasound Staging CT of abd/pelvis, chest if X-ray abnormal * TUMORI DEL TESTICOLO Pure seminoma accounts for 47% of all testis cancer patients (50% of patients with cryptorchidism have seminoma). More than 90% of the cases of pure seminoma are of the subtype called classic. These patients usually present with disease in the fourth or fifth decade. Approximately 75% of them present with stage I disease. Such patients may have modest elevations of serum beta?-human chorionic gonadotropin (beta?-HCG). It is worth noting that any elevation of alpha-fetoprotein connotes the presence of nonseminomatous germ cell tumor. Spermatocytic seminoma accounts for 7% of all seminomas. The median age of presentation is in the sixth and seventh decade of life. Because metastases are extraordinarily rare, orchiectomy is the only required treatment. Pathology: Seminoma Pathology: Non seminomatous Germ Cell Tumors Embryonal carcinoma Yolk sac carcinoma Choriocarcinoma Teratoma Diagnosis- Ultrasound. Most patients with testicular cancer present with a painless scrotal mass. This mass may be confused with epididymitis, particularly when pain is noted. Careful attention on physical examination, should generally discern a testicular mass from epididymitis. Testicular ultrasound will confirm the findings. Translumination of the testis may determine if the patient has a hydrocele; however, about 20% of patients with germ cell tumors of the testis will have a hydrocele. Testicular ultrasound is one of the most useful tools to evaluate a testicular mass. Findings r