Clinical meaning
Testicular cancer is the most common solid tumor in males aged 15-35, with germ cell tumors comprising over 95% of cases. Germ cell tumors are classified as seminomas (most common, radiosensitive, excellent prognosis) and non-seminomas (embryonal carcinoma, yolk sac tumor, choriocarcinoma, teratoma - more aggressive, chemosensitive). The typical presentation is a painless, firm testicular mass or swelling discovered by the patient or during examination. Cryptorchidism (undescended testicle) is the strongest risk factor, increasing cancer risk 4-8 fold even after orchiopexy. Tumor markers include alpha-fetoprotein (AFP, elevated in non-seminomas), beta-human chorionic gonadotropin (beta-hCG, elevated in seminomas and choriocarcinoma), and lactate dehydrogenase (LDH, correlates with tumor burden). Treatment typically involves radical inguinal orchiectomy followed by surveillance, radiation, or chemotherapy based on histology and staging. Cure rates exceed 95% even with metastatic disease.
Exam relevance
Risk factors: - Cryptorchidism (undescended testicle) - strongest risk factor - Personal or family history of testicular cancer - Age 15-35 years (peak incidence) - Caucasian race (4-5 times higher risk than African American) - Testicular microlithiasis on ultrasound