Testicular tumor
Revision as of 22:07, 24 March 2015 by Rossdonaldson1 (talk | contribs)
Background
- 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
- typically present with painless scrotal mass
Diagnosis
- 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
Work-Up
- testicular US
- UA
- CT of chest/abdomen/pelvis helpful for staging, only necessary in ED if patient has complaints related to this part of body
Differential Diagnosis
Testicular Diagnoses
- Scrotal cellulitis
- Epididymitis
- Fournier gangrene
- Hematocele
- Hydrocele
- Indirect inguinal hernia
- Inguinal lymph node (Lymphadenitis)
- Orchitis
- Scrotal abscess
- Spermatocele
- Tinea cruris
- Testicular rupture
- Testicular torsion
- Testicular trauma
- Testicular tumor
- Torsion of testicular appendage
- Varicocele
- Pyocele
- Testicular malignancy
- Scrotal wall hematoma
Treatment
- Urgent urology referral
Disposition
- Outpatient