Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgements
- PART I General concepts in oncology
- Part II Primary tumors
- 17 Lung cancer
- 18 Breast cancer
- 19 Colorectal cancer
- 20 Prostate cancer
- 21 Pancreatic and hepatobiliary cancer
- 22 Anal cancer
- 23 Esophageal and gastric cancer
- 24 Head and neck cancer
- 25 Kidney cancer
- 26 Bladder cancer
- 27 Ovarian cancer
- 28 Gynecologic malignancies: endometrial and cervical carcinoma
- 29 Testicular cancer
- 30 Unknown primary site cancer
- 31 Mesothelioma
- 32 Adult soft tissue sarcoma
- 33 Osteosarcoma and Ewing's sarcoma
- 34 Melanoma
- 35 Primary brain tumors
- 36 Thyroid and adrenal cancer
- 37 HIV-related cancer
- 38 Hodgkin's and non-Hodgkin's lymphoma
- 39 Leukemia, myelodysplastic syndrome and myeloproliferative disorder
- 40 Multiple myeloma
- Part III Management of specific symptoms and syndromes
- Index
- References
29 - Testicular cancer
Published online by Cambridge University Press: 04 August 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgements
- PART I General concepts in oncology
- Part II Primary tumors
- 17 Lung cancer
- 18 Breast cancer
- 19 Colorectal cancer
- 20 Prostate cancer
- 21 Pancreatic and hepatobiliary cancer
- 22 Anal cancer
- 23 Esophageal and gastric cancer
- 24 Head and neck cancer
- 25 Kidney cancer
- 26 Bladder cancer
- 27 Ovarian cancer
- 28 Gynecologic malignancies: endometrial and cervical carcinoma
- 29 Testicular cancer
- 30 Unknown primary site cancer
- 31 Mesothelioma
- 32 Adult soft tissue sarcoma
- 33 Osteosarcoma and Ewing's sarcoma
- 34 Melanoma
- 35 Primary brain tumors
- 36 Thyroid and adrenal cancer
- 37 HIV-related cancer
- 38 Hodgkin's and non-Hodgkin's lymphoma
- 39 Leukemia, myelodysplastic syndrome and myeloproliferative disorder
- 40 Multiple myeloma
- Part III Management of specific symptoms and syndromes
- Index
- References
Summary
Germ cell tumors (GCT) of the testis are the most common cancers of young men 15–35 years of age. Although relatively uncommon overall, their incidence has doubled over the past 40 years. Since the introduction of platinum-based combination regimens, the majority of patients with this disease are now cured.
Natural history
The majority (> 90%) of GCTs arise in the testis. Less common primary sites include the mediastinum, retroperitoneum, and the pineal/suprasellar region. Cryptorchism (the incomplete descent of one or both testes) is a well-defined risk factor for the development of this disease and the surgical correction of this problem (orchiopexy) performed prior to puberty reduces the risk for tumor development. Additional well-defined risk factors include a prior history of GCT and genetic syndromes including Klinefelter's and Down's syndromes.
Germ cell tumors can be divided by histologic type into seminomas (30%) and nonseminomatous germ cell tumors (NSGCT). Nonseminoma tumors may include any combination of the embryonal, endodermal sinus, choriocarcinoma, and teratoma histologies. A seminomatous component may also be present. The serum tumor markers human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) are often elevated in patients with either nonseminoma or seminoma, though elevated AFP is found only in patients with NSGCT and confirms the presence of a nonseminomatous component.
Pattern of spread and recurrence
The classic presentation of a testicular GCT is a painless scrotal mass though this finding occurs in only a minority of patients.
- Type
- Chapter
- Information
- Handbook of Advanced Cancer Care , pp. 247 - 253Publisher: Cambridge University PressPrint publication year: 2003