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Ljubav na djelu |  |
2014-08-21 |
Testicular tumor
Testicular tumors are relatively rare disease since they make up 1% of all malignancies in men. Yet, in many ways a special place in oncology. The most common malignancy in men aged 15 to 35 years. The products of these tumors, alfafetoproteins (AFP) and human choriogonadotropin (HCG) are considered today in oncology best serum tumor markers (markers). The most common among these tumors, testicular seminomas, most radiosensitive solid tumors. But the most important feature of testicular germ cell tumors (amount to more than 95% of all testicular tumors) is a real possibility chemotherapeutic cure of disseminated disease. Today, the only solid tumors in men who are after metastasis to distant parenchymal organs heal in more than 80% of patients
Symptoms:
· Nob painful hardening of one testicle.
· Diffuse thickening of the entire testicle..
· Pain low or medium intensity within the scrotum or lower abdomen.
· Gynecomastia (unilateral or bilateral) is present in 5% of patients.
In 10% of patients with metastatic symptomatology is caused by changes (pain in the lumbar area, lymphedema of the lower extremities, dry irritating cough, neurological symptoms of involvement of the central nervous system).
Diagnostic
Basic search a bimanual palpation and ultrasound examination is supplemented scrotal areas. The final confirmation of a diagnosis is histological analysis. The correct surgical approach testis through the inguinal and is contraindicated transscrotai access. In case of a positive finding process ends orchidectomy. Indispensable and radiological examination of retroperitoneal lymph nodes (CT), lung and mediastinum (X-ray and CT) and liver (ultrasound + CT). You are determined and serum tumor markers before and after orchiectomy (AFP, Beta. HCG and LDH).
Types:
The histological classification of testicular cancer:
· Germ tumors (germ) cells, make up 95% of all testicular tumors;
· Gonadal stromal tumors (tumors of Leydig and Sertoli cells, and androblastomi ginoblastomi) and lymphomas, consisting of 5% of all testicular tumors.
Germinaiv tumors are divided, according to the course of illness and treatment, the two groups:
· Seminomas, slow the spread exclusively via the lymphatics, not create AFP, and only 10% of sufferers have low to moderately elevated levels of beta-HCG. Seminomas are mostradiosensitiv solid tumors
· Nonseminomas, early hematogenous spread, creating AFP. Nonseminomas are moderately radiosensitive.
Minor differences exist in chemosensitivity or resistance to certain anticancer drugs. Closest symptomatology have epididymitis, orchitis, testicular torsion, hydrocele, hernia, hematoma, seamen cell.
Levels
After histological confirmation of testicular germ cell tumors should be determined by the degree of spread of the disease:
· Stage I - a disease confined to the testicle,
· Stage II - affected subdiaphragmatic lymph nodes,
· Stage III - supradiafragmal affected lymph nodes,
· Stage IV - there matogenous metastases (lung, liver, bones).
