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Primary tumours of the testis occur in men usually during 20 to 30 years of age.
About 90 per cent primary testicular tumours are germ cell tumours, which
include seminoma and non-seminoma. The remaining 10 per cent testicular tumours
are non-germ cell tumours, which include Leydig cell tumour, Sertoli cell
tumour and gonadoblastoma. The exact cause of testicular tumours is not fully
understood but there are certain risk factors, which include:
Primary testicular tumours usually present with
painless swelling of the testis. There may be a heaviness in the scrotum, weight
loss and fatigue. Intratesticular hemorrhage may occur leading to pain. There
may be obstruction of inferior vena cava leading to oedema in the lower
extremities. Involvement of retroperitoneal lymph nodes may cause backache.
There may be pulmonary metastases leading to cough. The cerebral metastases may
occur leading to a headache. In advanced stages of the germ cell testicular
tumour, there may be gynaecomastia and supraclavicular lymphadenopathy.
Procedures used in the diagnosis of a primary
testicular tumour includes:
Raised serum levels of human chorionic gonadotropin
(hCG), alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH) are indicators
of non-seminomas. The testicular biopsy is generally not recommended because
cutting through an outer capsule of the testis may contribute to metastases of the
tumour. Since most of the testicular tumours are malignant, the standard
surgical procedure is to remove the affected testis and send it for
histopathological examination.
Testicular self-examination (TSE) is recommended to
all the males once in a month to detect tumour of the testis at an early stage.
TSE should be done after a warm water bath that relaxes the scrotum, making it
easier to feel any abnormal growth. One should look for a lump in the testis;
enlargement of the testis; heaviness in the scrotum; and pain or tenderness in
the testis or the scrotum.
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Pallavi
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Primary Tumours of the Testis