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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 -
European Urology Focus Sep 2019Management of advanced testis cancer requires dedicated attention to the nuances of the disease to not only optimize cure but also ensure lifelong health. We are rapidly...
Management of advanced testis cancer requires dedicated attention to the nuances of the disease to not only optimize cure but also ensure lifelong health. We are rapidly entering an era of precision medicine with novel biomarker discoveries that will undoubtedly change the treatment paradigm in both early- and late-stage disease.
Topics: Humans; Male; Neoplasm Staging; Testicular Neoplasms
PubMed: 31563547
DOI: 10.1016/j.euf.2019.09.013 -
The Urologic Clinics of North America Aug 2015Testis cancer is the most commonly diagnosed cancer in young men. Most cases represent sporadic occurrences. Most commonly it presents at an early stage (clinical stage... (Review)
Review
Testis cancer is the most commonly diagnosed cancer in young men. Most cases represent sporadic occurrences. Most commonly it presents at an early stage (clinical stage I) and is highly curable with radical orchiectomy. Even more advanced stages of testicular cancer are curable with a multimodality treatment approach. There are no widely accepted screening strategies for germ cell tumors. This article discusses the known risk factors and epidemiology of testis cancer, the presentation, and work up for new patients, and the prognosis and cure rates based on the staging and current treatment modalities for testis cancer patients.
Topics: Adult; Biomarkers, Tumor; Early Detection of Cancer; Humans; Incidence; Male; Neoplasm Metastasis; Neoplasm Staging; Neoplasms, Germ Cell and Embryonal; Prognosis; Risk Assessment; Risk Factors; Self-Examination; Testicular Neoplasms; Testis; Ultrasonography
PubMed: 26216814
DOI: 10.1016/j.ucl.2015.04.001 -
World Journal of Urology Feb 2022The management of clinical stage II seminoma has evolved with a recent emphasis on minimizing long-term morbidity while achieving oncologic cure. (Review)
Review
INTRODUCTION
The management of clinical stage II seminoma has evolved with a recent emphasis on minimizing long-term morbidity while achieving oncologic cure.
METHODS
In this review we discuss the available management options for clinical stage II seminoma with an emphasis on the emerging role of surgery in this patient population.
RESULTS
Historically, treatment options available to clinical stage II seminoma patients were limited to radiotherapy and chemotherapy. Survival rates with these options are excellent; however, both are associated with significant long-term morbidities including cardiovascular, pulmonary, and neurologic toxicities. Additionally, higher rates of secondary malignancies are witnessed in this young patient population, decades after successful treatment of the primary cancer. Recently, retroperitoneal lymph node dissection has been proposed as a first-line treatment option for patients with low-volume metastatic seminoma.
CONCLUSION
The SEMS and PRIMETEST trials are two studies examining the role of primary retroperitoneal lymph node dissection in clinical stage II seminoma, and early data show significant promise.
Topics: Humans; Lymph Node Excision; Male; Neoplasm Staging; Neoplasms, Germ Cell and Embryonal; Retroperitoneal Space; Seminoma; Testicular Neoplasms
PubMed: 34655305
DOI: 10.1007/s00345-021-03854-8 -
Current Opinion in Oncology May 1997Although the concept that transplacentally acting estrogen-mimicking chemicals damage fetal germ cells is still the most favored hypothesis to explain the link between... (Review)
Review
Although the concept that transplacentally acting estrogen-mimicking chemicals damage fetal germ cells is still the most favored hypothesis to explain the link between declining sperm counts and rising testis cancer, there has been increasing recognition that other mechanisms may be contributing. With reports confirming the association between a sedentary lifestyle and rising incidence of testis cancer and a fourfold increased relative risk of delay in conception of more than 3 months found for those driving a vehicle for more than 3 hours a day, there is increasing recognition that heat may be one of the most important cofactors. The role of p53 in heat-mediated damage and deficiency of heat shock protein response of germ cells and germ cell cancer are providing increasing interest in the search for molecular mechanisms to explain the unique chemosensitivity of this group of tumors. Perhaps the most controversial report was the finding of mutations insufficient to block apoptosis in 67% of tumor p53 genes using a RNA-SSCP analysis, when only a quarter of them had mutations identified by conventional DNA sequencing. The acceptance that immunosuppression, whether HIV- or chemically induced, increases risk of germ cell cancer by 20 to 50 times that in the general population is perhaps the most important final confirmation of the immune-surveillance hypothesis, although there is no evidence as yet that it seriously worsens the chance of long-term cure in these patients. Further progress is being reported on the use of high-dose chemotherapy and stem-cell transplants, although the risks of treatment-related mortality still restrict its use to second line treatment. The problem of patient consent to the increasing range of options for early-stage disease is something highlighted from reports over the past year that will undoubtedly be an important issue in the future.
Topics: Biomarkers, Tumor; Germinoma; Humans; Male; Neoplasm Staging; Testicular Neoplasms
PubMed: 9229152
DOI: 10.1097/00001622-199709030-00012 -
Clinical Advances in Hematology &... May 2017The advances seen in the treatment of testicular cancer are among the great achievements in modern medicine. These advances were made possible by the collaborative... (Review)
Review
The advances seen in the treatment of testicular cancer are among the great achievements in modern medicine. These advances were made possible by the collaborative efforts of cancer researchers around the world. Investigators have been able to address many questions regarding the treatment of patients with disease limited to the testis, those with metastasis to the retroperitoneum only, and those with advanced metastatic disease. Questions answered include the chemotherapeutic agents to be used and in what combinations, the proper intensity of treatment and appropriate dosing, the optimal number of cycles of chemotherapy according to validated risk stratification, appropriate surgical approaches that preserve sexual function, the treatment of relapsed disease, what supportive care measures to take, and survivorship issues following treatment of testicular cancer. Today, cure is achievable in 95% of all patients with testicular cancer and 80% of those who have metastatic disease. Despite remarkable results with frontline and salvage combination chemotherapy, metastatic testicular cancer remains incurable in approximately 10% of patients, and novel treatment approaches are warranted. This review highlights past and recent discoveries in the treatment of patients with testicular cancer.
Topics: Combined Modality Therapy; Disease Management; Humans; Male; Molecular Targeted Therapy; Neoplasm Staging; Prognosis; Recurrence; Testicular Neoplasms; Treatment Outcome
PubMed: 28591093
DOI: No ID Found -
Annales de Pathologie Aug 2018Fibrothecal tumors belong to sex cord/stromal tumors (SCSTS). They represent 1 to 4.7 % of the organics tumors of ovary (Chechia et al., 2008) but are extremely rare... (Review)
Review
Fibrothecal tumors belong to sex cord/stromal tumors (SCSTS). They represent 1 to 4.7 % of the organics tumors of ovary (Chechia et al., 2008) but are extremely rare in the testis, with only a few cases described in the literature. We report a new case of a fibrothecoma in the testis in an adult. The extemporaneous diagnosis was made in the same time of the surgical intervention. The castration has been avoided.
Topics: Adult; Biomarkers, Tumor; Diagnosis, Differential; Humans; Male; Neoplasm Proteins; Sex Cord-Gonadal Stromal Tumors; Testicular Neoplasms
PubMed: 29803360
DOI: 10.1016/j.annpat.2018.04.001 -
Current Pharmaceutical Design 2015Malignant tumors aberrantly overexpress various embryonic genes and proto-oncogenes, including a variety of cancer-testis antigens (CTAs). CTAs belong to a class of... (Review)
Review
Malignant tumors aberrantly overexpress various embryonic genes and proto-oncogenes, including a variety of cancer-testis antigens (CTAs). CTAs belong to a class of testis-derived proteins which are only expressed in germ cells in the male testis, and the expression of CTA genes is entirely silenced in the adult somatic tissues. They are, however, aberrantly overexpressed in a variety of malignant tumor tissues. Emerging evidence shows that a number of CTAs promote epithelialmesenchymal transition (EMT) and genesis of cancer stem like cells, escalating tumorigenesis, invasion, and metastasis. The can cer-testis antigens, such as SSX, MAGE-D4B, CAGE, piwil2, and CT45A1, upregulate EMT and metastatic genes, promoting EMT and tumor dissemination. In addition, certain members of CTAs, including Piwil2, DNAJB8, CT45A1, MAGE-A, GAGE, and SPANX, are implicated in the initiation or maintenance, of cancer stem-like cells, promoting tumorigenesis and malignant progression. Clinically CTAs are closely associated with poor prognosis in cancer patients. Intriguely, CTAs are strongly immunogenic and normally restricted to the male testis after birth, however, these proteins are aberrantly overexpressed in cancer stem-like cells and in a variety of cancers, suggesting their target potential for cancer immunotherapy, as diagnostic biomarkers, and as targets for novel anticancer drug discovery. Thus, the targeting of tumorigenic CTAs is a promising strategy to eradicate cancer stem-like cells and inhibit tumorigenesis for effective cancer treatment.
Topics: Animals; Antigens, Neoplasm; Carcinogenesis; Epithelial-Mesenchymal Transition; Humans; Male; Neoplastic Stem Cells; Testicular Neoplasms
PubMed: 25506890
DOI: 10.2174/1381612821666141211154707 -
Surgical Pathology Clinics Dec 2022Testicular tumors are the most common solid tumors in young men, the vast majority of which are of germ cell origin. The staging of human cancers is paramount to correct... (Review)
Review
Testicular tumors are the most common solid tumors in young men, the vast majority of which are of germ cell origin. The staging of human cancers is paramount to correct patient management. Staging systems have passed through several developments leading to the release of the most recent 8th edition of the American Joint Committee for Cancer (AJCC) staging manual, which is based on the current understanding of tumor behavior and spread. In this review, the authors summarize the current AJCC staging of the germ cell tumors, highlight essential concepts, and provide insight into the most important parameters of testicular tumors.
Topics: Male; Humans; United States; Testicular Neoplasms; Neoplasms, Germ Cell and Embryonal; Neoplasm Staging; Prognosis
PubMed: 36344187
DOI: 10.1016/j.path.2022.07.010 -
Clinical & Translational Oncology :... May 2010Non-Hodgkin's lymphoma as a primary testicular neoplasm accounts approximately 9% of all testicular malignant tumours and about 1-2% of all non-Hodgkin's lymphoma. This... (Review)
Review
Non-Hodgkin's lymphoma as a primary testicular neoplasm accounts approximately 9% of all testicular malignant tumours and about 1-2% of all non-Hodgkin's lymphoma. This neoplasm is the most common malignant tumour of the testis in the elderly. The most common histotype in primary forms is the diffuse large B-cell lymphoma, whereas more aggressive histologies such as Burkitt's lymphoma are principal founded in cases of secondary involvement of the testis. Regarding clinical presentation, the most common sign is a unilateral painless scrotal swelling, sometimes with sharp scrotal pain or hydrocele. In patients with advanced stage, the systematic B symptoms are present in 25-41% of all cases. In 35% of patients, bilateral testicular involvement is detected. In more advanced stages with para-aortic lymph-node involvement, ascites and abdominal pain is evident. Despite the fact that responses to doxorubicin- containing chemotherapy, especially in early stages, show good results, relapses are often seen, and the prognosis of this tumour is very poor. Testicular lymphoma often disseminates to other extranodal organs, such as contralateral testis, central nervous system (CNS), lung, pleura, Waldeyer's ring and soft tissue. For patients with limited disease, the recommended first-line treatment is orchiectomy followed by rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) combination chemotherapy, with central nervous system (CNS) prophylaxis and prophylactic irradiation of the contralateral testis. In more advanced or relapsed disease, management should follow the worldwide recommendations for nodal diffuse large B-cell lymphoma (DLBCL). Here we present a review of this tumour.
Topics: Disease Progression; Humans; Lymphoma; Male; Neoplasm Metastasis; Neoplasm Staging; Prognosis; Testicular Neoplasms
PubMed: 20466616
DOI: 10.1007/s12094-010-0513-9