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Testicular Cancer

  • Brian Missett
  • Alexander R. Gottschalk
Chapter

Abstract

Spermatogenesis: spermatogonia → spermatocytes → spermatids → spermatozoa. Takes ∼2 months in adult men. LN drainage. L testicle: testicular vein → L renal vein → paraaortic LN. R testicle: testicular vein → IVC below level of renal vein → paracaval and aortocaval nodes. Prior inguinal surgery may disrupt drainage and redirect through iliac nodes. Pathology: >95% are germ cell tumors (GCTs) = seminomas and nonseminomatous germ cell tumors (NSGCTs). Sixty percent of tumors are mixed and 40% are pure (seminoma most common pure). Seminoma is the most common single histology, but together NSGCTs are more common. Seminoma subtypes: classic (>90% of cases, stains + for PLAP) and spermatocytic (older age, cured by orchiectomy, rarely metastasizes, stains negative for PLAP). Anaplastic no longer considered a subtype. NSGCTs subtypes: embryonal carcinoma (most common NSGCT), yolk sac tumor (elevated AFP, Schiller Duval bodies), choriocarcinoma (elevated β-hCG, rarest pure GCT), teratoma, and mixed GCTs. Other tumors: Sertoli cell tumors (produce estrogen, present with gynecomastia); Leydig cell tumors (produce androgens and estrogen, present with early puberty, gynecomastia); lymphoma; embryonal rhabdomyosarcoma. Risk factors: undescended testicle, first-born, pre/perinatal estrogen exposure, polyvinyl chloride exposure, advanced maternal age, Down’s syndrome, Klinefelter’s syndrome (47XXY), CIS, HIV/AIDS.

Keywords

Renal Vein Testicular Cancer Embryonal Carcinoma Undescended Testicle Early Puberty 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

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Further Reading

  1. Becherer A, De Santis M, Karanikas G, et al. FDG PET is superior to CT in the prediction of viable tumour in post-chemotherapy seminoma residuals. Eur J Radiol 2005;54(2):284-248.PubMedCrossRefGoogle Scholar
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  3. Hussey D, Meistrich M. The Testicle. In: Cox JD, Ang KK, editors. Radiation oncology: rationale, technique, results. 8th ed. St. Louis: Mosby; 2003. pp. 605-628.Google Scholar

Copyright information

© Springer-Verlag New York 2010

Authors and Affiliations

  • Brian Missett
    • 1
  • Alexander R. Gottschalk
    • 2
  1. 1.Radiation OncologyKaiser Permanente Santa ClaraSanta ClaraUSA
  2. 2.Radiation OncologyUniversity of California San FranciscoSan FranciscoUSA

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