View source for Testicular tumor

==Background==
[[File:Gray1144.png|thumb|Scrotal anatomy]]
[[File:Figure 28 01 03.jpg|thumb|Testicular anatomy]]
*Most common malignancy in young men, 1% all cancers in men
*Increased frequency in: infertile patients, whites, undescended testis, history of cryptorchidism
*95% germ cell tumors: half seminomas, half mixed types (teratomas, choriocarcinomas, yolk sac tumors)
*5% sex cord stromal tumors

==Clinical Features==
*Typically present with painless scrotal mass, dull lower abdominal ache, or heaviness sensation
*May have endocrine abnormalities from hCG elevations<ref>Harris M et al. Testicular tumour presenting as gynaecomastia. BMJ. 2006 Apr 8; 332(7545): 837.</ref><ref>Voigt W et al. Human chorionic gonadotropin-induced hyperthyroidism in germ cell cancer--a case presentation and review of the literature. Onkologie. 2007 Jun;30(6):330-4.</ref>
**Gynecomastia
**Hyperthyroid biochemical signs

==Differential Diagnosis==
{{Testicular DDX}}

==Evaluation==
===Work-Up===
*Testicular US
*[[Urinalysis]]
*CT of chest/abdomen/pelvis helpful for staging, only necessary in ED if patient has complaints related to this part of body

===Evaluation===
*Testicular US
*If pain must rule out epididymitis, torsion
*May present with mets at time of diagnosis
**15% present with mets to regional lymph nodes
**5% present with mets to abdomen or pelvis
*Urology may ask for LDH, AFP, hCG tumor markers<ref>Testicular Cancer: Version 1.2015. National Comprehensive Cancer Network. Available at http://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf.</ref>
**Ensure follow up and document carefully, since EPs will not follow up on results
**If no admission is arranged, consider deferring ordering tumor markers to consultants

==Management==
*Urgent urology referral

==Disposition==
*Outpatient

==See Also==
*[[Testicular diagnoses]]

==References==
<references/>
[[Category:Urology]]