Malignant Testicular Tumors

Malignant testicular tumors are rare but serious types of cancer that account for about 1% of all tumors in men. They occur with a frequency of 20-25 per 1 million men and are most often diagnosed at the age of 20-35 years. Factors predisposing to the development of tumors include cryptorchidism, late testicular descent (after 2 years), trauma, and others.

There are germ cell tumors arising from the seminiferous epithelium and non-germ tumors arising from hormone-producing cells and from the stroma. Germ cell tumors account for 95% of all testicular tumors and are divided into two main types: seminomas (40%) and nonseminomas (60%). Non-seminoma tumors are often mixed and consist of different components, including seminoma.

Seminomas are more often found in people over 30 years of age, while non-seminomas are usually diagnosed in patients between 20 and 36 years of age. Symptoms of testicular tumors include a painless, gradually enlarging lump that may be noticed by the patient during self-palpation. The main symptoms are associated with metastasis to the retroperitoneal lymph nodes, which leads to lower back pain, as well as metastasis to the lungs, which can lead to cough and hemoptysis. Gynecomastia is often observed in patients with testicular tumors.

A biochemical blood test for nonseminoma tumors reveals alpha-fetoprotein, and for testicular chorionepithelioma, the content of human chorionic gonadotropin increases in the urine.

Various methods are used to diagnose testicular malignancies, including intravenous urography, retroperitoneal ultrasound, computed tomography and angiography. These methods make it possible to establish metastases in the retroperitoneal space.

Treatment of malignant testicular tumors begins with orchofuniculectomy - surgery to remove the testicle. After histological examination of the tumor, treatment tactics may be different. In case of seminoma without metastases, we can limit ourselves to removing the primary tumor focus. In the presence of retroperitoneal metastases, radiation therapy is carried out according to a radical program. If metastases are detected in the lungs or other organs, chemotherapy is indicated using various medications, such as sarcolysine, cyclophosphamide, cisplatin, vinblastine and others.

In patients with nonseminoma tumors, if retroperitoneal metastases are suspected, they are surgically removed transperitoneally on both sides, after which chemotherapy is prescribed. If removal of retroperitoneal metastases is impossible, 5-6 courses of chemotherapy are administered according to the appropriate regimen. If after chemotherapy the patient still has metastases, they are removed surgically.

There is an effective treatment strategy for malignant testicular tumors, which can cure 70-80% of patients. However, as with other types of cancer, the success of treatment depends on many factors, including the stage of the tumor, the patient's age and the presence of comorbidities.

It is important to note that regular examinations by a urologist, including self-palpation of the testicles, can help in the early detection of testicular malignancies and increase the chances of successful treatment. If any suspicious changes are detected, you should immediately consult a doctor.