Testicular Cancer - Clinical Medicine

Explore the most common solid malignancy affecting young adult men through this comprehensive 57-minute clinical medicine lecture. Delve into the epidemiology and pathophysiology of testicular cancer, examining key risk factors including cryptorchidism, family history, prior testicular cancer, and genetic conditions that contribute to malignant transformation within the germinal epithelium. Learn to distinguish between seminomas and nonseminomatous germ cell tumors (NSGCTs), understanding their different growth patterns, metastasis tendencies, and treatment responses. Master the clinical presentation, focusing on the characteristic painless unilateral testicular mass and recognizing symptoms of metastatic spread such as back pain, cough, or supraclavicular lymphadenopathy. Understand the critical role of tumor markers—AFP, β-hCG, and LDH—in both diagnosis and follow-up care, emphasizing their diagnostic specificity for different tumor subtypes. Navigate the diagnostic approach using scrotal ultrasound as first-line imaging, staging with CT of the abdomen and pelvis, and learn why transscrotal biopsy must be avoided to prevent tumor seeding. Review evidence-based management strategies tailored to staging and tumor type, including radical inguinal orchiectomy, radiation therapy for seminomas, and chemotherapy regimens for advanced disease, providing essential knowledge for clinical practice in oncology and urology.