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Publicatie

Neoplastic lesions of scrotum

Boekbijdrage - Hoofdstuk

Testicular neoplasms account for 1–2% of all neoplasms in males and are the most common cancer type found in men ages 15- to 40-years-old. Clinical evaluation of a suspected scrotal neoplasm is initially based on the patient history and physical exam. The most common presentation of testicular cancer involves a painless scrotal mass or swelling, with acute testicular pain present in some cases. Concerning clinical findings should prompt further workup with an ultrasound and serum tumor markers, which can be used to help further narrow down the differential diagnosis. Definitive diagnosis is achieved via histological analysis. Characterization of the testicular tumor type is based on its histological analysis and pathogenesis, as per the most recent 2016 World Health Organization classification system. Together with staging, tumor classification is used to develop an appropriate treatment plan. While there are several diverse types of testicular tumors, 95% are classified as germ cell tumors, with the majority of testicular tumors in men ≤50 years of age classified as malignant germ cell tumors. An important concept regarding scrotal neoplasms is that until proven otherwise, a hard intratesticular mass should be regarded as cancerous. Therefore, a suspected tumor during workup is an indication for a radical transinguinal orchiectomy, providing tissue for the histological diagnosis in addition to a therapeutic treatment. Adjuvant post-orchiectomy therapies include retroperitoneal lymph node dissection, radiation therapy, and chemotherapy. Urologists treating testicular cancer patients should provide pre-treatment counseling on the potential impact on fertility along with the option of sperm banking. Various initiatives should be implemented to help minimize disparities and prevent diagnostic delays in testicular cancer. In particular, testicular self-examination may be used to help screen for testicular cancer and help increase the survival rate to give more years of life to patients.
Boek: Normal and abnormal scrotum
Pagina's: 341 - 374
ISBN:9783030833053
Jaar van publicatie:2022
Toegankelijkheid:Closed