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Oncology - ABIM

Testicular cancer

QuestionAnswer
What are the two types of testicular cancer? How can you tell the difference between the two? Seminoma and non-seminoma. Non-seminoma have elevated AFP and elevated beta hCG. Sometimes beta hCG is elevated in seminoma, but you can always use AFP to distinguish between the two because it will never be elevated in seminomas.
In addition to treating for non-seminoma, what else do you need to do if the patient has increased AFP? CT of the liver to rule out hepatocellular carcinoma
Seminoma stage I – what is it and how to treat? stage one – confined to testes. First do radical orchiectomy via high inguinal incision, then radiation therapy
Seminoma stage II – what is it and how to treat? Stage II – involve in infradiaphragmatic nodes that are <5 cm. First do radical orchiectomy via high inguinal incision, then radiation therapy.
Seminoma stage III – what is it and how to treat? Stage III – beyond retroperitoneal nodes, >5 cm. First do radical orchiectomy via high inguinal incision, then chemotherapy.
Non-seminoma stage one – what is it and how to treat? Stage I – confined to testes. First, do radical orchiectomy by a high inguinal incision, then observe. Remove lymph nodes in high-risk patients.
Non-seminoma stage II – what is it and how to treat? Stage II – involve infra diaphragmatic nodes, <5 cm. First, do radical orchiectomy via high inguinal incision, then chemotherapy.
Non-seminoma stage III – what is it and how to treat? Stage III – beyond retroperitoneal lymph nodes, >5 cm. First, do radical orchiectomy by a high inguinal incision, then chemotherapy.
At what stage do you treat non-seminoma with radiation therapy? Never
Created by: christinapham