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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:


  • Testicular atrophy - Due to trauma or infection
  • Cryptorchidism
  • Klinefelter's syndrome - Small testes, enlarged breasts and lack of secondary sex characters in males
  • Gonadal aplasia - Failure of the testicular development
  • Hermaphroditism
  • Low weight at birth


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.


  • In stage I, the primary testicular tumour is localised within the testis.
  • In stage II, the tumour involves abdominal lymph nodes.
  • In stage III, the tumour involves other organs of the body such as the liver and the lungs.
  • A recurrent testicular tumour is the one that reappears after an apparent recovery in response to the initial treatment.


Procedures used in the diagnosis of a primary testicular tumour includes:


  • Ultrasound
  • CT scan
  • Intravenous pyelography (IVP)
  • Lymphangiography
  • MRI


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.


This content is for information and educational purposes only and should not be perceived as medical advice. Please consult a certified medical or healthcare professional before making any decision regarding your health using the content above.

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