Testicular germ cell tumor

Testicular germ cell tumor (TGCT) is a type of cancer that originates in the testicles. It is the most common form of testicular cancer, accounting for around 95% of all cases. TGCTs can be broadly classified into two types: seminomas and non-seminomas, each with distinct clinical and pathological features.

Epidemiology

TGCTs are most common in men aged between 15 and 35 years, but can occur at any age. The incidence of TGCTs has been increasing over the past few decades, particularly in developed countries. The reasons for this increase are not fully understood, but may be related to changes in lifestyle and environmental factors.

Pathogenesis

TGCTs originate from germ cells, which are the cells responsible for producing sperm. The exact cause of TGCTs is unknown, but several risk factors have been identified, including a history of cryptorchidism (undescended testicles), family history of TGCTs, and certain genetic syndromes, such as Klinefelter syndrome.

Clinical Presentation

The most common symptom of a TGCT is a painless lump in the testicle. Other symptoms may include testicular pain or discomfort, a feeling of heaviness in the scrotum, or a sudden collection of fluid in the scrotum. Some men may also experience symptoms related to metastatic disease, such as back pain or shortness of breath.

Diagnosis

The diagnosis of a TGCT is usually confirmed by ultrasound of the testicles, followed by a biopsy of the tumor. Blood tests may also be performed to measure levels of certain tumor markers, such as alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG).

Treatment

The primary treatment for TGCTs is surgical removal of the affected testicle, a procedure known as orchiectomy. Depending on the stage and type of the tumor, additional treatments may be required, including chemotherapy, radiation therapy, and/or additional surgery to remove any metastatic disease.

Prognosis

The prognosis for TGCTs is generally good, with a 5-year survival rate of over 95% for localized disease. However, the prognosis can be significantly worse for advanced disease or for certain types of non-seminomas.

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