"TYPES
Germ cell tumours (95%)
A. Seminoma 45%
B. Teratoma 50%
Stromal tumours (5%)
A. Leydig cell tumour
B. Sertoli cell tumour
AGE INCIDENCE
Teratomas- 25 years
Seminomas - 40 years
RISK FACTORS:
Cryptorchidism increases risk 10-fold.
PRESENTATION
1. Painless lump 90%
2. Recent onset hydrocoele.
3. Pain
4. Gynaecomastia- f rom ?hCG production.
5. Metastasis - seminomas metastasise to para-aortic nodes - back pain;
teratomas =blood-borne spread to liver
lung
bone and brain.
INVESTIGATION:
Ultrrasound - All men with a recent onset hydrocele should have an US.
STAGING:
Stage 1: Disease conf ined to the testis.
Stage 2: metastasis to Paraaortic ly mph nodes below the diaphragm.
Stage 3: metastasis to nodes abov e diaphgram.
Stage 4: Extra ly mphatic metastases - liver and lung"