ReasonDx: Testicular Cancer

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About ReasonDx: Testicular Cancer

Testicular cancer is a malignancy arising from germ cells or stromal cells within the testicles, most commonly affecting men aged 15-35 years. It represents one of the most curable solid organ malignancies when detected early, with cure rates exceeding 95% even in advanced stages.

Pathophysiology

The majority of testicular cancers (95%) originate from germ cells, developing into either seminomas or non-seminomatous germ cell tumors (NSGCTs) including embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma. Risk factors include cryptorchidism, family history, and previous testicular cancer, with genetic predisposition involving chromosomal abnormalities and oncogene activation leading to uncontrolled cellular proliferation.

Clinical Reasoning

Diagnosis relies on physical examination revealing a painless testicular mass, scrotal ultrasound for confirmation, and serum tumor markers (AFP, β-hCG, LDH) for staging and monitoring. The differential diagnosis includes benign conditions like epididymitis, hydrocele, or torsion, making imaging and tumor markers crucial for accurate diagnosis and appropriate staging with CT imaging to determine treatment approach.

References

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Imaging Reasoning

Ultrasound with Doppler

Key imaging focus: Absent blood flow (torsion), intratesticular mass, hydrocele, epididymal changes

📚 Radiopaedia Cases →
  1. Testicular Cancer - StatPearls. StatPearls / NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK563163/