Testicular cancer differential diagnosis: Difference between revisions

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Revision as of 17:06, 23 January 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]

Overview

Testicular cancer must be differentiated from epididymitis, hematocele, hydrocele, spermatocele, granulomatous orchitis, and varicocele.

Differentiating Testicular cancer from other Diseases

Testicular cancer must be differentiated from:

									Pain	Mass	Physical examination	Lab Findings	Imaging
Diseases		Benign/ Malignant	Unilateral/Bilateral	History	Demography	Metastasis	Genetics	Histopathology	Clinical manifestations			Para-clinical findings
									Pain	Mass	Physical examination	Para-clinical findings
Germ Cell	Seminoma^[1]^[2]	Malignant	Unilateral	History of cryptorchidism Excellent prognosis	Most common among age of 15-35 years old Does not occur during infancy	Late metastasis	Stains positively for: ALP C-KIT CD30 EMA Glycogen	Large cells wit watery cytoplasm Fried egg appearance	-	+	Palpable, nontender unilateral testicular mass Usually homogeneous enlargement	Elevated serum placental ALP (PALP)	Ultrasound: Homogeneous hypoechoic intratesticular mass Cysts and calcificications are uncommon Inhomogenous feature in larger mass
	Embryonal carcinoma	Malignant	Usually located in parenchyma of testis May be nonpalpable	Hemorrhagic mass with necrosis Worse prognosis than seminoma	Rare type Peak incidence at the age of 30 years old Usually mixed with other types	Early metastasis to: retroperitoneum Lung Liver	Stains positively for: CD30 HCG May stain positively for : AFP, when mixed with other tumors	Primitive epithelial cells with marked pleomorphism Often mixed histopathological features (solid, papillary, tubular, pseudoglandular)	+	±	Unremarkable May present with abdominal/ pelvic mass Abdominal pain may be present	Elevated serum hCG Elevated serum AFP, when mixed with other tumor types	Ultrasound: Usually hypoechoic mass Invasion to tunica albuginea Irregular calcifications
	Yolk sac tumor
	Teratoma
	Choriocarcinoma
Diseases		Benign/ Malignant	Unilateral/Bilateral	History	Demography	Metastasis	Genetics	Histopathology	Pain	Mass	Physical exam	Lab Findings	Imaging
Non germ cell	Leydig cell tumor
	Sertoli cell tumor
	Testicular lymphoma
Carcinoma in situ of the testicle

References

↑ Siegel RL, Miller KD, Jemal A (2016). "Cancer statistics, 2016". CA Cancer J Clin. 66 (1): 7–30. doi:10.3322/caac.21332. PMID 26742998.
↑ Miller FH, Whitney WS, Fitzgerald SW, Miller EI (1999). "Seminomas complicating undescended intraabdominal testes in patients with prior negative findings from surgical exploration". AJR Am J Roentgenol. 172 (2): 425–8. doi:10.2214/ajr.172.2.9930796. PMID 9930796.

Template:WikiDoc Sources

[pmid26742998-1] Siegel RL, Miller KD, Jemal A (2016). "Cancer statistics, 2016". CA Cancer J Clin. 66 (1): 7–30. doi:10.3322/caac.21332. PMID 26742998.

[pmid9930796-2] Miller FH, Whitney WS, Fitzgerald SW, Miller EI (1999). "Seminomas complicating undescended intraabdominal testes in patients with prior negative findings from surgical exploration". AJR Am J Roentgenol. 172 (2): 425–8. doi:10.2214/ajr.172.2.9930796. PMID 9930796.

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[2]

@@ Line 61: / Line 61: @@
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" | Embryonal carcinoma
+| style="background: #F5F5F5; padding: 5px;" |Malignant
 | style="background: #F5F5F5; padding: 5px;" |
+* Usually located in parenchyma of testis
+* May be nonpalpable
 | style="background: #F5F5F5; padding: 5px;" |
+* Hemorrhagic mass with necrosis
+* Worse prognosis than seminoma
 | style="background: #F5F5F5; padding: 5px;" |
+* Rare type
+* Peak incidence at the age of 30 years old
+* Usually mixed with other types
+| style="background: #F5F5F5; padding: 5px;" |Early metastasis to:
+* retroperitoneum
+* Lung
+* Liver
+| style="background: #F5F5F5; padding: 5px;" |Stains positively for:
+* CD30
+* HCG
+May stain positively for :
+* AFP, when mixed with other tumors
 | style="background: #F5F5F5; padding: 5px;" |
+* Primitive epithelial cells with marked pleomorphism
+* Often mixed histopathological features (solid, papillary, tubular, pseudoglandular)
+| style="background: #F5F5F5; padding: 5px;" |+
+| style="background: #F5F5F5; padding: 5px;" |±
 | style="background: #F5F5F5; padding: 5px;" |
+* Unremarkable
+* May present with abdominal/ pelvic mass
+* Abdominal pain may be present
 | style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
+* Elevated serum hCG
-| style="background: #F5F5F5; padding: 5px;" |
+* Elevated serum AFP, when mixed with other tumor types
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |Ultrasound:
-| style="background: #F5F5F5; padding: 5px;" |
+* Usually hypoechoic mass
-| style="background: #F5F5F5; padding: 5px;" |
+* Invasion to tunica albuginea
-| style="background: #F5F5F5; padding: 5px;" |
+* Irregular calcifications
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |Yolk sac tumor

Testicular cancer differential diagnosis: Difference between revisions

Revision as of 17:06, 23 January 2019

Overview

Differentiating Testicular cancer from other Diseases

References

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