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Testicular cancer Diagnosis and Treatment
Testicular cancer Diagnosis and Treatment
Testicular tumors are rare and mainly in children (about 30% of all tumors of childhood), and young people. In general, male testicular tumors account for about 1% of all malignant neoplasms.
The main factors contributing to their development, are:
cryptorchism
testicular trauma
Klinefelter's syndrome
microwave, X-ray and gamma radiation
infertility.
The most frequently develop such tumors as seminoma, embryonal testicular cancer, yolk sac tumor, poliembrioma, teratoma, horionkartsinoma. The histological type of tumor may be one of the listed or mixed. The degree of tumor differentiation and may be different. There are germ (embryonic origin) and negerminogennye testicular tumors, and the share of adult germ cell tumors account for 95% of cases. These include the seminoma - a cancer of the testicle, growing from the spermatogenic epithelium. Neseminomnye tumors often of mixed descent. The most frequently encountered in this combination of "teratoma + embryonal carcinoma." The most aggressive course characterized choriocarcinoma.
Local spread of testicular tumors seen an increase in testicular size, germination in other parts of his (appendage, spermatic cord, testis sheath). At this stage (when there is no immediate and distant metastases) can be detected about 40% of patients. It is for this group and the outcomes are most favorable. Regional metastasis of testicular tumors in the lymphatic system characterized by retroperitoneal lymph nodes and less often in the groin or pelvis. Hematogenous metastasis is most characteristic in the lung tissue.
Clinic of testicular tumors usually begins with the identification of unilateral dense nodules increase in size, changing the shape of the testicle or the scrotum. At the initial stage of the tumor is usually painless, but as it grows there is pain, both in the testis and in the course of the spermatic cord. There may be pain in the lower abdomen as a result of metastasis in regional lymph nodes. Distant metastasis can provide clinical manifestations in the relevant organs and tissues. In the presence of hormonally active tumors, changes of secondary sexual characteristics: gynecomastia (breast enlargement), early puberty, hirsutism (excessive body hair), etc.
Diagnosis of testicular cancer.
Initial diagnosis is reduced to the inspection and palpation of the testicles, palpation of lymph nodes, breast examination. For the simplest and at the same time, well informative instrumental study include transillumination (candling eggs narrow beam of light).
They are used as standard clinical and laboratory studies:
blood tests and urine
Biochemical analysis of blood
determination of protein fractions, etc.
Widely used methods of medical imaging:
ultrasonic methods
X-ray computed tomography
magnetic resonance imaging
X-ray methods.
They can not only detect the presence and characteristics of tumor growth, but also to assess the surrounding tissues, which reveals the presence of nearby and distant metastases.
Particular attention is paid to the definition of specific tumor markers:
alpha-fetoprotein (AFP)
carcinoembryonic antigen (CEA)
human chorionic gonadotropin beta (HGTch).
Sometimes referred to the above markers and lactate dehydrogenase (LDH). The appearance of these markers in diagnostically significant quantities indicates the activation of oncogenes and tumor as a whole.
Treatment of testicular cancer.
The treatment of cancer and other malignancies the testicle is usually complex. Combining radiation therapy with surgery and chemotherapy gives the best results today. Quality of treatment depends primarily on the following factors:
timely detection of tumor
radical removal of the primary tumor
quality preoperative irradiation
removal of regional lymph nodes
postoperative chemotherapy (chemotherapy)
Each stage has its own characteristics depending on the type of tumor. Thus, germ cell tumors (especially seminoma) respond better to initial radiation therapy, and some types of tumors are treated quite successfully by surgery only. Prevention of malignant tumors of the testis is reduced to prevent the factors that contribute to their development, particularly kriptorhisma, injury and exposure of genitals.
