- Infertility (increases risk by a factor of 3)
- Family history
- Klinefelter's syndrome
- Mumps orchitis
- Non-seminomas: including embryonal, yolk sac, teratoma and choriocarcinoma
Non-germ cell tumours include Leydig cell tumours and sarcomas.
- A painless lump is the most common presenting symptom
- Pain may also be present in a minority of men
- Other possible features include hydrocele, gynaecomastia
- AFP is elevated in around 60% of germ cell tumours
- LDH is elevated in around 40% of germ cell tumours
- Seminomas: hCG may be elevated in around 20%
Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for testicular cancer in men if they have a non‑painful enlargement or change in shape or texture of the testis.
Consider a direct access ultrasound scan for testicular cancer in men with unexplained or persistent testicular symptoms.
- Ultrasound is first-line
- Treatment depends on whether the tumour is a seminoma or a non-seminoma
- Chemotherapy and radiotherapy may be given depending on staging and tumour type
- 5 year survival for seminomas is around 95% if Stage I
- 5 year survival for teratomas is around 85% if Stage I