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Seminoma

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95% of testicular tumors are what type of tumor? What are the 2 subtypes and generally how does their treatment differ?
germ cell tumors are 95% of testicular tumors. of these, 40% are pure seminomas and ajunctive RT is standard of care. 60% are non-seminomas and RT is palliative
Testicular cancer accounts for only 2% of cancer. What has happened to the incidence in the past 40 yrs?
The incidence of testicular cancer has doubled in the past 40 yrs.
What are the main risk factors for testicular tumors?
men aged 15-34, h/o cryptochidism, assoc w/ dysplastic nevus synd and Klinefelter's synd, HIV infxn, race: 5x increase in white vs blk, chromosomal abnorm in chromo 1+12
pure seminomas account for __% of germ cell tumors. What are the 3 subtypes? Which is most common?
1. Classic Seminoma 85%
2. Anaplastic Seminoma
3. Spermatocytic Seminoma
non-seminomas acct for __% of germ cell tumors. What are the main types?
Non-seminomas are 60% of germ cell tumors. 1. embryonal 2. teratoma 3. choriocarcinoma 4. mixed
germ cell tumors are __% of testicular tumors while non-germ cell tumors are __%. What are subtypes of the non-germ cell tumors?
Testicular tumors: germ cell (95%), non-germ cell (5%)
(stromal and lymphoma)
Germ cell tumors frequently produce proteins that can serve as tumor markers for disease burden/diagnosis. What are 3 most important ones?
alpha-feto protein (AFP)
beta-HCG
LDG
characteristic serum marker elevation in seminomas
AFP should be zero
may produce some HCG
half life of AFP
4-6 days
half life of b-HCG
1-2 days
what might account for the gynecomastia in 5% of the testicular cancer patients?
the elevated HCG
why are scrotal incisions contraindicated if suspicion is high for a testicular tumor?
concern for altering the lymphatic pattern of drainage
what are the clincal prognostic factors in seminomas?
only stage and disease burden are of clinic significance. the histologic subtype and serum HCG are not of prognostic value

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