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 select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process 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 Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.