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American Family Physician Feb 2018Testicular cancer is the most common solid tumor among males 15 to 34 years of age, with an estimated 8,850 new cases and 410 deaths during 2017 in the United States.... (Review)
Review
Testicular cancer is the most common solid tumor among males 15 to 34 years of age, with an estimated 8,850 new cases and 410 deaths during 2017 in the United States. With effective treatment, the overall five-year survival rate is 97%. Risk factors for testicular cancer include undescended testis (cryptorchidism), personal or family history of testicular cancer, age, ethnicity, and infertility. The U.S. Preventive Services Task Force recommends against routine screening in asymptomatic men. Men with symptoms should receive a complete history and physical examination. Scrotal ultrasonography is the preferred initial imaging study. If a solid intratesticular mass is discovered, orchiectomy is both diagnostic and therapeutic. Staging through chest radiography, chemistry panel, liver function tests, and tumor markers guides treatment. Active surveillance, chemotherapy, retroperitoneal lymph node dissection, and radiation therapy are treatment options following orchiectomy. For patients desiring future fertility, sperm banking should be discussed early in the course of treatment. Family physicians often play a role in the care of cancer survivors and should be familiar with monitoring for recurrence and future complications, including secondary malignant neoplasms, cardiovascular risk, and infertility and subfertility.
Topics: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; Curriculum; Education, Medical, Continuing; Humans; Male; Neoplasm Recurrence, Local; Neoplasms, Second Primary; Practice Guidelines as Topic; Preventive Medicine; Risk Factors; Testicular Neoplasms; United States; Young Adult
PubMed: 29671528
DOI: No ID Found -
Journal of Medical Case Reports Jan 2021The importance of this paper is to help to emphasize the importance of chemotherapy for children with pure intratesticular rhabdomyosarcoma after radical inguinal... (Review)
Review
BACKGROUND
The importance of this paper is to help to emphasize the importance of chemotherapy for children with pure intratesticular rhabdomyosarcoma after radical inguinal orchiectomy is done as first treatment of rhabdomyosarcoma. The information provided in this paper about the follow-up outcomes of the patient described in this paper, it highlights that, recurrence and even metastasis of intratesticular rhabdomyosarcoma in children are more likely to occur if surgery it not combined with chemotherapy.
CASE PRESENTATION
Herein, we present a 6-year old African male child with a 3 months history of a painless right intratesticular tumour. The tumour was poorly vascularized and was in continuity with the spermatic cord. Pelvic computer tomography (CT) scan showed a heterogeneous mass with well-defined margins without microcalcification and multiple bilateral inguinal enlarged lymph nodes were noticed without pelvic lymphadenopathy. The tumour measured 3.8 × 2.8 × 3.9 cm. The tumour marker panel showed: lactate dehydrogenase of (472 UI/l), alpha-fetoprotein (1.43 UI/ml) and human chorionic gonadotrophin beta (2.9 mUI/ml). Microscopically, the tumour was composed of small to medium size undifferentiated cells. These were oval to spindle, hyperchromatic cells to stromal myxoid degeneration were noted. Tunica albuginea and rete testis both were infiltrated by tumour. The tumour showed high mitotic count which measured 50 mitoses per 10 High Power Field (HPF). The diagnosis of rhabdomyosarcoma (RMS) was confirmed by immunohistochemistry (IHC) testing using myoD antibody which showed strong and diffuse intranuclear staining of the tumour cells. Currently, he is on cyclophosphamide and vincristine chemotherapy regime and his condition has improved much.
CONCLUSIONS
The experience obtained from the index case is crucial for the management of patients with intratesticular rhabdomyosarcoma which should always make sure that radical inguinal orchiectomy is covered by chemotherapy and/or radiotherapy. This will potentially lower the possibilities of recurrence and/or metastasis of the tumour, hence improving the prognosis of the patients. We report the clinical, radiological, and laboratory characteristics as well as the outcome of the patient.
Topics: Child; Cyclophosphamide; Humans; Male; Neoplasm Recurrence, Local; Orchiectomy; Rhabdomyosarcoma; Rhabdomyosarcoma, Embryonal; Testicular Neoplasms
PubMed: 33516251
DOI: 10.1186/s13256-020-02599-z -
Deutsches Arzteblatt International Dec 2023Germ-cell tumors of the testes are the most common type of malignant tumor in men aged 20 to 40. Their incidence in Germany is 10 per 100 000 men per year, with an... (Review)
Review
BACKGROUND
Germ-cell tumors of the testes are the most common type of malignant tumor in men aged 20 to 40. Their incidence in Germany is 10 per 100 000 men per year, with an estimated 4200 new cases annually.
METHODS
This selective review is based on the recommendations of the German clinical practice guideline on the diagnosis, treatment and follow-up care of testicular germ-cell tumors, as well as on pertinent original articles and reviews.
RESULTS
The treatment of germ-cell tumors requires an interdisciplinary approach comprising resection of the affected testis followed by further steps that depend on the histological type and stage of the tumor, which may include active surveillance, chemotherapy, radiotherapy, further surgery, or some combination of these measures. Two-thirds of germ-cell tumors are diagnosed in clinical stage I, when they are still confined to the testis; one-third are already metastatic when diagnosed, with organ metastases in 10-15%. Stage-based multimodal treatment approaches are associated with cure rates of more than 99% for stage I tumors and 67-95% for advanced metastatic disease, depending on the degree of progression.
CONCLUSION
For patients with early-stage tumors, overtreatment should be avoided in order to minimize long-term sequelae. For those whose tumors are in advanced stages, it must be decided which patients should receive intensified treatment to optimize the outcome. Multimodal treatment approaches are associated with high cure rates even for patients with metastatic disease.
Topics: Male; Humans; Testicular Neoplasms; Neoplasms, Germ Cell and Embryonal; Combined Modality Therapy; Germany; Disease Progression
PubMed: 37378600
DOI: 10.3238/arztebl.m2023.0143 -
Postgraduate Medical Journal Oct 2007Testis cancer is an increasing problem, especially in northern European male populations. However, survival has improved dramatically over one generation. Environmental... (Review)
Review
Testis cancer is an increasing problem, especially in northern European male populations. However, survival has improved dramatically over one generation. Environmental factors may have a role in the aetiology with high oestrogen concentrations implicated. Testis cancer is subdivided between seminoma and non-seminoma. At presentation, a testicular lump is the most common finding and radical inguinal orchidectomy is recommended for most. Further multidisciplinary management is determined by histological subtype and stage and involves chemotherapy, radiotherapy and surgery, with many patients only undergoing surveillance. There is increasing emphasis on reducing toxicity of treatments in long term survivors. Treatment refractory testis cancer remains a significant challenge.
Topics: Diagnosis, Differential; Humans; Male; Risk Factors; Testicular Neoplasms
PubMed: 17916870
DOI: 10.1136/pgmj.2007.057992 -
Ugeskrift For Laeger Mar 2023This case report describes Fournier's gangrene in a 35-year-old male following elective inguinal orchiectomy for testicular cancer. The aetiology was unknown, possibly...
This case report describes Fournier's gangrene in a 35-year-old male following elective inguinal orchiectomy for testicular cancer. The aetiology was unknown, possibly beginning in the bottom of the scrotum following orchiectomy, alternatively through the scrotal skin after hair removal prior to surgery. Survivors from Fournier's gangrene often suffer from severe long-term morbidity, and multidisciplinary treatment is important for outcome optimization.
Topics: Humans; Male; Adult; Fournier Gangrene; Testicular Neoplasms; Orchiectomy; Scrotum; Pelvis
PubMed: 36896604
DOI: No ID Found -
International Journal of Molecular... May 2023Spermatocytic tumor (ST) is a very rare disease, accounting for approximately 1% of testicular cancers. Previously classified as spermatocytic seminoma, it is currently... (Review)
Review
Spermatocytic tumor (ST) is a very rare disease, accounting for approximately 1% of testicular cancers. Previously classified as spermatocytic seminoma, it is currently classified within the non-germ neoplasia in-situ-derived tumors and has different clinical-pathologic features when compared with other forms of germ cell tumors (GCTs). A web-based search of MEDLINE/PubMed library data was performed in order to identify pertinent articles. In the vast majority of cases, STs are diagnosed at stage I and carry a very good prognosis. The treatment of choice is orchiectomy alone. Nevertheless, there are two rare variants of STs having very aggressive behavior, namely anaplastic ST and ST with sarcomatous transformation, that are resistant to systemic treatments and their prognosis is very poor. We have summarized all the epidemiological, pathological and clinical features available in the literature regarding STs that have to be considered as a specific entity compared to other germ GCTs, including seminoma. With the aim of improving the knowledge of this rare disease, an international registry is required.
Topics: Male; Humans; Seminoma; Rare Diseases; Testicular Neoplasms; Orchiectomy; Sarcoma; Neoplasms, Germ Cell and Embryonal
PubMed: 37298487
DOI: 10.3390/ijms24119529 -
International Journal of Surgery... Dec 2023Testis-sparing surgery (TSS) is a safe treatment for patients with benign testicular tumors. Presently, assessments for evaluating the suitability of TSS are poorly...
BACKGROUND
Testis-sparing surgery (TSS) is a safe treatment for patients with benign testicular tumors. Presently, assessments for evaluating the suitability of TSS are poorly standardized, partially because testicular anatomical elements cannot be quantitatively described.
MATERIALS AND METHODS
The authors developed a scoring method known as the SAVE testis-sparing score based on four critical and accessible anatomical features of a testicular tumor. The SAVE score ranges from 0 to 8 and is divided into four risk classes ( low , medium , high , and extremely high ) to evaluate the feasibility of TSS, wherein low-risk indicates high feasibility and vice versa. This study included 444 testicular tumor patients from eight centers. Among them, 216 patients (model group: 151 patients, validation group: 65 patients) were included in the modeling analysis, and the other 228 patients from children's centers were included in the proportion analysis. Using retrospective data, patient characteristics associated with surgical methods were identified. Furthermore, a multivariate logistic regression model was built quantify the associations between these characteristics and the surgery method. The receiver operator characteristic curve was used to evaluate the classification efficiency of SAVE.
RESULTS
The SAVE testis-sparing score includes size (tumor size as maximal diameter), available testicular tissue volume, volume ratio of the tumor to the testis, and the exophytic / endophytic properties of the tumor. The SAVE scoring system accurately classified the suitability of TSS based on the complexity of benign testicular tumors.
CONCLUSION
The SAVE score is a reproducible and robust tool for quantitatively describing the anatomical characteristics of benign testicular tumors and guide the preoperative evaluation of TSS.
Topics: Male; Child; Humans; Retrospective Studies; Orchiectomy; Organ Sparing Treatments; Testicular Neoplasms
PubMed: 37738014
DOI: 10.1097/JS9.0000000000000752 -
Endocrinology and Metabolism Clinics of... Mar 2022In parallel with increased survival rates, quality of life (QoL) has become of growing importance in the management of young cancer survivors. Several surveys have... (Review)
Review
In parallel with increased survival rates, quality of life (QoL) has become of growing importance in the management of young cancer survivors. Several surveys have indicated that in those subjects, the issue of reproductive function is considered as one of the main QoL aspects. In this article, we summarize the current evidence, as well as gaps of knowledge and research needs, regarding the impact of cancer and cancer treatment on testicular function-including fertility and androgen production. Also, pre and posttherapy clinical management of reproductive issues in male cancer survivors, are given.
Topics: Cancer Survivors; Fertility; Humans; Male; Quality of Life; Surveys and Questionnaires; Testicular Neoplasms
PubMed: 35216715
DOI: 10.1016/j.ecl.2021.11.014 -
Journal of the National Medical... Nov 2007We evaluated clinical features, management and survival of 12 patients with primary testicular non-Hodgkin's lymphoma presented to our hematology unit between January...
We evaluated clinical features, management and survival of 12 patients with primary testicular non-Hodgkin's lymphoma presented to our hematology unit between January 1992 and July 2006, retrospectively. The median age of patients was 47 years at presentation (range 29-78 years) and > 80% of them were < 50 years old. In the majority of cases, orchidectomy was performed as diagnostic and first-line therapeutic procedures. Dominant histological subtype was diffuse large B-cell non-Hodgkin's lymphoma. Seven patients out of 12 (58%) were Ann Arbor stages I and II, and the remaining five patients (42%) were stages III and IV. All the patients received doxorubicin-based chemotherapy and achieved complete remission. The addition of rituximab and central nervous system prophylaxis with intrathecal combined chemotherapy containing methotrexate, cytarabine and dexametasone were applied to three patients who were recently admitted. The rate of relapse was 8% and progression-free survival (PFS) at 10 years was 88%. Median duration of response was 84 months (range 14-173 months), median 97.5 months of follow-up. All patients are alive and in case remission. Because of the spreading nature and relapse probability at different sites, including central nervous system and contralateral testis, systemic treatment with doxorubicin-based chemotherapy with or without prophylaxis for contralateral testis and the central nervous system seems to improve the outcome of primary testicular lymphoma.
Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Disease Progression; Doxorubicin; Humans; Lymphoma, Non-Hodgkin; Male; Middle Aged; Neoplasm Recurrence, Local; Orchiectomy; Prednisone; Prognosis; Retrospective Studies; Survival; Testicular Neoplasms; Treatment Outcome; Turkey; Vincristine
PubMed: 18020104
DOI: No ID Found -
World Journal of Urology Feb 2022
Topics: Humans; Male; Testicular Neoplasms; Testis
PubMed: 35226139
DOI: 10.1007/s00345-022-03957-w