Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ INTRODUCTION ++ Epidemiology Table Graphic Jump Location|Download (.pdf)|Print Epidemiology Incidence: 9610 estimated new cases for 2020 in the United States 5.9 per 100,000 males per year Most common malignancy in males ages 15–39 Deaths: Estimated 440 in 2020 Median age: 33 years American Cancer Society Facts and Figures 2020: Special Section: Cancer in Adolescents and Young Adults Siegel RL et al. CA Cancer J Clin 2020;70:7–30 Surveillance, Epidemiology and End Results (SEER) Program, available from http://seer.cancer.gov [accessed in 2020] Table Graphic Jump Location|Download (.pdf)|Print Frequency of Stage at Presentation Seminoma Nonseminoma Stage I 85% 60% Stage II 10% 20% Stage III 5% 20% Frequency of IGCCCG Risk Groups at Diagnosis for Patients Requiring Chemotherapy IGCCCG Risk Group Seminoma Nonseminoma All Good 90% 56% 60% Intermediate 10% 28% 26% Poor N/A 16% 14% IGCCCG, International Germ Cell Cancer Collaborative Group; GCT germ cell tumor Biggs M, Schwartz S. Cancer of the testis. In Ries LAG et al (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988–2001. Bethesda, MD: National Cancer Institute; 2007. Bosl G et al. In Devita V et al (editors). Cancer: Principles and Practice of Oncology. Philadelphia: Lippincott Williams and Wilkins; 2008:1463–1485 International Germ Cell Cancer Collaborative Group (IGCCCG). J Clin Oncol 1997;15:594–603 Siegel R et al. CA Cancer J Clin 2014;64:9–29 ++ Pathology Table Graphic Jump Location|Download (.pdf)|Print Pathology Germ Cell Tumors (95%) Non–Germ Cell Tumors (5%) Derived from germ cell neoplasia in situ (GCNIS) Seminoma Nonseminoma i) Embryonal carcinoma ii) Trophoblastic tumor – Choriocarcinoma – Other trophoblastic tumors iii) Yolk-sac tumor, postpubertal type iv) Teratoma, postpubertal type – Teratoma with somatic malignancy Not derived from GCNIS Spermatocytic tumor Yolk-sac tumor, prepubertal type Teratoma, prepubertal type Note: Most common nonseminoma histology is a mixture of ≥2 histologies. Pure teratoma represents a fully malignant GCT Sex cord-stromal (gonadal stromal) tumors Leydig cell Sertoli cell tumor Granulosa cell tumor Tumors in the fibroma-thecoma group Mixed and unclassified sex-cord stromal tumors Both germ cell and gonadal stromal elements Gonadoblastoma Adnexal and paratesticular tumors Mesothelioma Carcinoma of rete testis Miscellaneous neoplasms Carcinoid Lymphoma Sarcoma Other Moch H et al. World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs. 4th ed. Lyon: IARC Press; 2016 ++ Work-up Table Graphic Jump Location|Download (.pdf)|Print Work-up Suspicious Testicular Mass (by History or Exam) Confirmed Testicular Mass (by Ultrasound) Seminoma or Nonseminoma (S/P Orchiectomy) History and physical STM if not yet done STM AFP, hCG, and LDH (serum tumor markers [STM]) CBC, complete metabolic profile CBC, complete metabolic profile CBC, complete metabolic profile CT A/P + either CXR or CT chest Nonseminoma: CT A/P if >4 weeks since prior; CT chest if not previously performed Seminoma: CT A/P and CXR if >4 weeks since prior Scrotal ultrasound Bone scan or brain MRI, only if clinically indicated; sperm banking should ... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth